Chen Gang, Li Guangling, Zhang Demei, Wang Xiaomei, Guo Xueya
Department of Cardiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China.
Department of Cardiology, Lanzhou University Second Hospital, The Second Clinical Medical College of Lanzhou University, Lanzhou, China.
Front Cardiovasc Med. 2023 Jul 20;10:1071950. doi: 10.3389/fcvm.2023.1071950. eCollection 2023.
Antiarrhythmic drugs (AADs) are frequently prescribed following catheter ablation (CA) for atrial fibrillation (AF). However, to date, there is a lack of large-scale, multicenter controlled studies that have confirmed the efficacy of AADs in reducing the incidence of late recurrence of AF after CA. Furthermore, the optimal duration of short-term use of AADs after CA remains a controversial topic.
PubMed, Embase, Cochrane Library, CNKI, and ClinicalTrials.gov were searched until April 25, 2022. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess the efficacy of blanking period AADs in predicting both early and late recurrence of AF. In addition, Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the quality of evidence in this meta-analysis.
12 RCTs with 3,625 patients were included in this meta-analysis. Short-term use of AADs after AF ablation reduced the risk of early recurrence of AF compared with the no-AADs group. In the subgroup analysis of AADs use time, it was found that only using AADs for more than 2 months can reduce the early recurrence of AF after CA. However, when compared with the no-AADs group, short-term use of AADs after CA did not reduce the incidence of late recurrence of AF.
Short-term use of AADs (more than 2 months) can reduce the early recurrence but not the late recurrence of AF after CA.
房颤（AF）导管消融（CA）术后常使用抗心律失常药物（AADs）。然而，迄今为止，缺乏大规模、多中心对照研究证实AADs在降低CA术后房颤晚期复发率方面的疗效。此外，CA术后短期使用AADs的最佳时长仍是一个有争议的话题。
检索截至2022年4月25日的PubMed、Embase、Cochrane图书馆、中国知网和ClinicalTrials.gov。我们对随机对照试验（RCTs）进行了荟萃分析，以评估空白期使用AADs对预测房颤早期和晚期复发的疗效。此外，使用推荐分级评估、制定和评价（GRADE）来评估该荟萃分析中的证据质量。
本荟萃分析纳入了12项RCTs，共3625例患者。房颤消融术后短期使用AADs与未使用AADs组相比，降低了房颤早期复发风险。在AADs使用时间的亚组分析中，发现仅使用AADs超过2个月可降低CA术后房颤的早期复发。然而，与未使用AADs组相比，CA术后短期使用AADs并未降低房颤晚期复发率。
短期使用AADs（超过2个月）可降低CA术后房颤的早期复发，但不能降低晚期复发。
