Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation-A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled Trials.

<h4>Background</h4>The efficacy of short-term antiarrhythmic drugs (AADs) use compared with no-AADs prescription after catheter ablation of atrial fibrillation (AF) in preventing atrial arrhythmia recurrence is uncertain.<h4>Methods</h4>We searched PubMed, Embase, and the Coc...

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Main Authors: Weijie Chen, Hang Liu, Zhiyu Ling, Yanping Xu, Jinqi Fan, Huaan Du, Peilin Xiao, Li Su, Zengzhang Liu, Xianbin Lan, Bernhard Zrenner, Yuehui Yin
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0156121
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author Weijie Chen
Hang Liu
Zhiyu Ling
Yanping Xu
Jinqi Fan
Huaan Du
Peilin Xiao
Li Su
Zengzhang Liu
Xianbin Lan
Bernhard Zrenner
Yuehui Yin
author_facet Weijie Chen
Hang Liu
Zhiyu Ling
Yanping Xu
Jinqi Fan
Huaan Du
Peilin Xiao
Li Su
Zengzhang Liu
Xianbin Lan
Bernhard Zrenner
Yuehui Yin
author_sort Weijie Chen
collection DOAJ
description <h4>Background</h4>The efficacy of short-term antiarrhythmic drugs (AADs) use compared with no-AADs prescription after catheter ablation of atrial fibrillation (AF) in preventing atrial arrhythmia recurrence is uncertain.<h4>Methods</h4>We searched PubMed, Embase, and the Cochrane Library through December 2015 to identify randomized controlled trials (RCTs) which evaluated the efficacy of short-term AADs use compared with no-AADs prescription after AF ablation in preventing atrial arrhythmia recurrence. The primary outcome was labeled as early atrial arrhythmia recurrence within 3 months after ablation. Secondary outcome was defined as late recurrence after 3 months of ablation. Random-effects model or fixed-effects model was used to estimate relative risks (RRs) with 95% confidence intervals (CIs).<h4>Results</h4>Six RCTs with 2,667 patients were included into this meta-analysis. Compared with no-AADs administration after AF ablation, short-term AADs use was associated with significant reduction of early atrial arrhythmia recurrence (RR, 0.68; 95% CI, 0.52-0.87; p = 0.003). Trial sequential analysis (TSA) showed that the cumulative Z-curve crossed the trial sequential monitoring boundary for benefit, establishing sufficient and conclusive evidence. However, compared with no-AADs prescription, short-term AADs use after AF ablation didn't significantly reduce the risk of late atrial arrhythmia recurrence (RR, 0.92; 95% CI, 0.83-1.03; p = 0.15). TSA supported this result; meanwhile the estimated required information size (1,486 patients) was also met.<h4>Conclusion</h4>Short-term use of AADs after AF ablation can significantly decrease the risk of early atrial arrhythmia recurrence but not lead to corresponding reduction in risk of late atrial arrhythmia recurrence.
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spelling doaj-art-3d0e0afd670d44019666ea92e14631ca2025-08-20T03:14:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01115e015612110.1371/journal.pone.0156121Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation-A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled Trials.Weijie ChenHang LiuZhiyu LingYanping XuJinqi FanHuaan DuPeilin XiaoLi SuZengzhang LiuXianbin LanBernhard ZrennerYuehui Yin<h4>Background</h4>The efficacy of short-term antiarrhythmic drugs (AADs) use compared with no-AADs prescription after catheter ablation of atrial fibrillation (AF) in preventing atrial arrhythmia recurrence is uncertain.<h4>Methods</h4>We searched PubMed, Embase, and the Cochrane Library through December 2015 to identify randomized controlled trials (RCTs) which evaluated the efficacy of short-term AADs use compared with no-AADs prescription after AF ablation in preventing atrial arrhythmia recurrence. The primary outcome was labeled as early atrial arrhythmia recurrence within 3 months after ablation. Secondary outcome was defined as late recurrence after 3 months of ablation. Random-effects model or fixed-effects model was used to estimate relative risks (RRs) with 95% confidence intervals (CIs).<h4>Results</h4>Six RCTs with 2,667 patients were included into this meta-analysis. Compared with no-AADs administration after AF ablation, short-term AADs use was associated with significant reduction of early atrial arrhythmia recurrence (RR, 0.68; 95% CI, 0.52-0.87; p = 0.003). Trial sequential analysis (TSA) showed that the cumulative Z-curve crossed the trial sequential monitoring boundary for benefit, establishing sufficient and conclusive evidence. However, compared with no-AADs prescription, short-term AADs use after AF ablation didn't significantly reduce the risk of late atrial arrhythmia recurrence (RR, 0.92; 95% CI, 0.83-1.03; p = 0.15). TSA supported this result; meanwhile the estimated required information size (1,486 patients) was also met.<h4>Conclusion</h4>Short-term use of AADs after AF ablation can significantly decrease the risk of early atrial arrhythmia recurrence but not lead to corresponding reduction in risk of late atrial arrhythmia recurrence.https://doi.org/10.1371/journal.pone.0156121
spellingShingle Weijie Chen
Hang Liu
Zhiyu Ling
Yanping Xu
Jinqi Fan
Huaan Du
Peilin Xiao
Li Su
Zengzhang Liu
Xianbin Lan
Bernhard Zrenner
Yuehui Yin
Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation-A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled Trials.
PLoS ONE
title Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation-A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled Trials.
title_full Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation-A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled Trials.
title_fullStr Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation-A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled Trials.
title_full_unstemmed Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation-A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled Trials.
title_short Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation-A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled Trials.
title_sort efficacy of short term antiarrhythmic drugs use after catheter ablation of atrial fibrillation a systematic review with meta analyses and trial sequential analyses of randomized controlled trials
url https://doi.org/10.1371/journal.pone.0156121
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