COMPARISON OF EFFECTIVENESS OF ANTIARRHYTHMIC THERAPIES IN POSTOPERATIVE PERIOD OF PULMONARY VEIN OSTIA CATHETER ISOLATION FOR PREVENTION OF EARLY RECURRENCES OF ATRIAL TACHYARRHYTHMIAS IN THE PROOF STUDY

Abstract

. Aim. To study the effectiveness of antiarrhythmic drugs: propafenone, sotalol and verapamil for the prevention of recurrence of atrial fibrillation (AF) and other atrial tachyarrhythmias in the early postoperative period after pulmonary vein ostia catheter isolation in patients with paroxysmal AF.Material and methods. Patients (n=243) were included into a prospective, comparative, open-label, randomized study with a control. They were divided into 4 groups: Patients of Group 1 (n=61) received verapamil retard 240 mg/day., Group 2 (n=62) – propafenone 450 mg/day, group 3 (n=60) – sotalol 160 mg/day. Patients of control Group 4 (n=60) did not receive antiarrhythmic drugs. Patient's diary, ECG, 24-hour Holter ECG monitoring, and percutaneous heart monitor were used to detect arrhythmias in the early postoperative period.Results. During the first 3 months of postoperative period we registered 8.62±9.37 pharmacological cardioversions in Group 2, 13.24±10.77 in Group 1 (p=0.013), and 11.93±12.02 in Group 3 (p=0.123). Besides we performed 0.40±1.03 electrical cardioversions in Group 2, 1.016±1.74 in Group 1 (p=0.024), and 1.033±1.52 in Group 3 (p=0.0096). A number of hospitalizations was 0.447±0.57 in Group 2, 0.684±0.73 in Group 1 (p=0.0012), and 0.592±0.67 in Group 3 (p=0.074). Conclusion. Better clinical effectiveness for prevention of atrial tachyarrhythmias recurrence in the early postoperative period was found in the propafenone group.

Keywords

• atrial fibrillation
• radiofrequency ablation of pulmonary veins
• the early postoperative period
• verapamil
• propafenone
• sotalol
• proof study