Amiodarone prevention for atrial fibrillation relapse after surgical ablation

Abstract

Background: Atrial fibrillation (AF) is the most common heart rhythm disorder. AF ablation based on endovascular or surgical techniques is a standard of care in everyday practice. Early recurrence of atrial arrhythmias is a significant problem after ablative procedures. Prophylactic use of antiarrhythmic drugs has become a possible solution. Materials and methods: We performed a retrospective observational cohort study of 59 patients with heart disease requiring surgery under extracorporeal circulation (ECC) and have received radiofrequency ablation (RFA) for chronic or persistent AF with a successful conversion to sinus rhythm. Patients were divided into two groups: 36 were treated with amiodarone for three months postoperatively (treatment group), and 23 had no concomitant amiodarone therapy (control group). We compared the groups regarding freedom from recurrent atrial arrhythmia and the frequency of conduction disorders requiring permanent pacemaker implantation. Results: No differences between the groups were found regarding demographic characteristics, risk profile, and heart diseases indicating cardiac surgery. During follow-up, a significantly higher proportion of patients with sinus rhythm in the group receiving amiodarone was found (80.56% vs. 52.17%; p < 0.041). No cases of premature discontinuation of amiodarone for side effects or noncompliance were registered in the treatment group. Conclusion: Three months of amiodarone therapy post-surgical RFA of AF is an effective and safe strategy for relapse prevention.