Xu Buyun, Peng Fang, Tang Weiliang, Du Ye, Guo Hangyuan
Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China.
Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, China
Ann Pharmacother. 2016 Sep;50(9):697-705. doi: 10.1177/1060028016653140. Epub 2016 Jun 16.
The incidence of recurrent arrhythmia after catheter ablation (CA) for atrial fibrillation (AF) is unacceptable. Short-term antiarrhythmic drug (AAD) treatment following CA was presumed to be effective in reducing recurrent arrhythmia.
To fully evaluate the efficacy of short-term use of AADs following CA for AF in preventing recurrence of atrial tachyarrhythmias.
PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched up until May 1, 2016. We enrolled randomized controlled trials (RCTs) that evaluated the efficacy of short-term use of AADs following CA for AF in preventing early and/or late recurrence of atrial tachyarrhythmias. The statistical analyses were performed using Review Manager Version 5.3.
Six RCTs were included in this analysis, involving a total of 2764 patients. The frequency of early recurrence of atrial tachyarrhythmias was 39.5% in the AAD group (556 of 1407) and 47.2% (640 of 1357) in the control group. The pooled risk ratio of the AAD group to the control group was 0.78 (95% CI = 0.62-0.98). Regarding late recurrence of AF (LRAF), the incidence in the AAD group and the control group was 32.5% (420 of 1293) and 34.6% (450 of 1300), respectively. No significant difference was identified between the 2 groups (relative risk = 0.94, 95% CI = 0.85-1.05).
Short-term use of AADs following CA for AF reduced the incidence of early recurrent atrial tachyarrhythmias but did not prevent LRAF.
心房颤动（AF）导管消融（CA）术后心律失常复发率令人难以接受。CA术后短期抗心律失常药物（AAD）治疗被认为可有效降低心律失常复发率。
全面评估AF患者CA术后短期使用AAD预防房性快速性心律失常复发的疗效。
检索截至2016年5月1日的PubMed、Embase、Cochrane图书馆和ClinicalTrials.gov。纳入评估AF患者CA术后短期使用AAD预防房性快速性心律失常早期和/或晚期复发疗效的随机对照试验（RCT）。使用Review Manager 5.3进行统计分析。
本分析纳入6项RCT，共涉及2764例患者。AAD组房性快速性心律失常早期复发率为39.5%（1407例中的556例），对照组为47.2%（1357例中的640例）。AAD组与对照组的合并风险比为0.78（95%CI = 0.62 - 0.98）。关于AF晚期复发（LRAF），AAD组和对照组的发生率分别为32.5%（1293例中的420例）和34.6%（1300例中的450例）。两组之间未发现显著差异（相对风险 = 0.94，95%CI = 0.85 - 1.05）。
AF患者CA术后短期使用AAD可降低早期房性快速性心律失常复发率，但不能预防LRAF。
