Discontinuation of anti-arrhythmic drugs in patients receiving hybrid therapy consisting of catheter ablation and bepridil for persistent atrial fibrillation

Koichi Inoue, Toshiya Kurotobi, Hiroshi Itoh, Ryusuke Kimura, Yuko Toyoshima, Norihisa Itoh, Yoshiharu Higuchi, Motoo Date, Yasushi Koyama, Katsuomi Iwakura, Kenshi Fujii

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Abstract

Background: Anti-arrhythmic drugs (AADs) are often administered following catheter ablation (CA) for persistent atrial fibrillation (peAF) to maintain sinus rhythm (SR). It remains unclear whether AADs can be withdrawn in patients showing no recurrence after CA. Method: We administered hybrid therapy consisting of CA and AAD (bepridil) in 75 patients with peAF. Withdrawal of AADs was attempted in patients who had no recurrence of AF for ≥6 months. We followed them for 22716 months. Results: Patients received 1.270.4 sessions of CA and a mean bepridil dose of 131746 mg/day. After a 3-month "blanking period", 62 (83%) patients maintained SR without recurrence of tachyarrhythmia for ≥6 months. AADs were discontinued in 41 patients who agreed to medication withdrawal. Ten of these (24%) experienced a relapse of tachycardia, and these patients had a higher incidence of residual inducibility of tachyarrhythmia at the end of the CA procedure (70% vs. 32%; P=0.03) and required a higher dose of bepridil to maintain SR (170748 mg vs. 106730 mg; P

Original languageEnglish
Pages (from-to)170-174
Number of pages5
JournalJournal of Arrhythmia
Volume28
Issue number3
DOIs
Publication statusPublished - Jun 2012

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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