Effect of Antiarrhythmic Drug Treatment on the Clinical Recurrence Rate of Atrial Arrhythmia Within 90 Days After Primary Pulmonary Vein Isolation

Background This study examines the impact of antiarrhythmic drug treatment on the frequency and timing of clinical atrial arrhythmia recurrence within 90 days postintervention. Methods We retrospectively investigated a control group without antiarrhythmic drug ( n = 50) and a treatment group with antiarrhythmic drug ( n = 50) within the blanking period. Subgroup analysis was based on the pre-interventional heart rhythm (atrial fibrillation or sinus rhythm) and the timing of antiarrhythmic drug initiation. The primary endpoint was the clinical recurrence rate of atrial arrhythmia within 90 days postprimary pulmonary vein isolation. Secondary endpoints included time to first clinical recurrence and recurrence rate in the prespecified subgroups. Results No difference in clinical atrial arrhythmia recurrence rate was observed between the treatment group (32%) and the control group (24%, P = .51) or between the subgroups. First clinical recurrence of atrial arrhythmia occurred earlier in the treatment group (median 12 days (interquartile range 29)) compared to the control group (43 days (interquartile range 46), P = .04). Conclusion There was no difference in the frequency of clinical atrial arrhythmia recurrences in patients with and without antiarrhythmic drugs. However, patients with atrial fibrillation and antiarrhythmic drug treatment started before pulmonary vein isolation showed an earlier first clinical recurrence of atrial arrhythmia.