Comparing the Impact of Different Antiarrhythmic Classes on Clinical Outcomes Following Atrial Fibrillation Catheter Ablation
<b>Background/Objectives</b>: Catheter ablation has become the standard of care for patients with symptomatic and drug-refractory atrial fibrillation (AF). Both Class IC and Class III antiarrhythmic drugs (AADs) are effective in preventing early recurrences of AF, but not late recurrence...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-07-01
|
| Series: | Pharmaceuticals |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1424-8247/18/7/1022 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849733665976745984 |
|---|---|
| author | Andrej Belančić Yusuf Ziya Sener Metin Oksul Cansu Ozturk Serdar Soner Adnan Duha Comert Gamze Yeter Arslan Dinko Vitezić Bojan Jelaković Erkan Baysal |
| author_facet | Andrej Belančić Yusuf Ziya Sener Metin Oksul Cansu Ozturk Serdar Soner Adnan Duha Comert Gamze Yeter Arslan Dinko Vitezić Bojan Jelaković Erkan Baysal |
| author_sort | Andrej Belančić |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Catheter ablation has become the standard of care for patients with symptomatic and drug-refractory atrial fibrillation (AF). Both Class IC and Class III antiarrhythmic drugs (AADs) are effective in preventing early recurrences of AF, but not late recurrences, compared with the usual care. We aimed to compare the effects of two months of Class IC versus Class III AADs following AF catheter ablation on clinical outcomes, including arrhythmia recurrence and safety endpoints. <b>Methods</b>: All patients undergoing AF catheter ablation between January 2015 and November 2024 were screened, and cases meeting the inclusion criteria were included. Primary outcome was defined as atrial tachycardia recurrence-free survival. <b>Results</b>: A total of 98 patients (mean age 54.2 ± 14.0 years; 55.1% male) were enrolled, with 66.3% presenting with paroxysmal atrial fibrillation (AF). The mean left atrial diameter was 38.7 ± 5.1 mm, and 78.6% underwent cryoballoon ablation. Class IC AADs were administered to 62 cases, while the remaining 36 patients received amiodarone following catheter ablation. The rate of atrial tachycardia (ATa) recurrence was comparable between the patients treated with Class IC and Class III AADs (9.7% vs. 19.4%; <i>p</i> = 0.169). Predictors of ATa recurrence were identified as history of direct current cardioversion—DCCV (HR: 5.86; 95%CI: 1.44–23.82)—and LA diameter (HR: 1.17; 95%CI: 1.04–1.31). The most frequent AAD-related adverse event was symptomatic bradycardia (6.1%), which resolved in all cases following dose reduction. <b>Conclusions</b>: Class IC and Class III antiarrhythmics show comparable efficacy in terms of preventing ATa recurrence following AF catheter ablation. AAD-related adverse event rates are negligible for short-term use. |
| format | Article |
| id | doaj-art-7aff64a4f18e47808bfafaf4a7a8f028 |
| institution | DOAJ |
| issn | 1424-8247 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj-art-7aff64a4f18e47808bfafaf4a7a8f0282025-08-20T03:07:58ZengMDPI AGPharmaceuticals1424-82472025-07-01187102210.3390/ph18071022Comparing the Impact of Different Antiarrhythmic Classes on Clinical Outcomes Following Atrial Fibrillation Catheter AblationAndrej Belančić0Yusuf Ziya Sener1Metin Oksul2Cansu Ozturk3Serdar Soner4Adnan Duha Comert5Gamze Yeter Arslan6Dinko Vitezić7Bojan Jelaković8Erkan Baysal9Department of Basic and Clinical Pharmacology with Toxicology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, CroatiaDepartment of Cardiology, Thoraxcenter, Erasmus University Medical Center, 51000 Rotterdam, The NetherlandsDepartment of Cardiology, Gazi Yasargil Training and Research Hospital, 21010 Diyarbakir, TürkiyeDepartment of Cardiology, Gazi Yasargil Training and Research Hospital, 21010 Diyarbakir, TürkiyeDepartment of Cardiology, Gazi Yasargil Training and Research Hospital, 21010 Diyarbakir, TürkiyeDepartment of Cardiology, Gazi Yasargil Training and Research Hospital, 21010 Diyarbakir, TürkiyeDepartment of Cardiology, Kepez State Hospital, 07320 Antalya, TürkiyeDepartment of Basic and Clinical Pharmacology with Toxicology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, CroatiaDepartment of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, 10000 Zagreb, CroatiaDepartment of Cardiology, Gazi Yasargil Training and Research Hospital, 21010 Diyarbakir, Türkiye<b>Background/Objectives</b>: Catheter ablation has become the standard of care for patients with symptomatic and drug-refractory atrial fibrillation (AF). Both Class IC and Class III antiarrhythmic drugs (AADs) are effective in preventing early recurrences of AF, but not late recurrences, compared with the usual care. We aimed to compare the effects of two months of Class IC versus Class III AADs following AF catheter ablation on clinical outcomes, including arrhythmia recurrence and safety endpoints. <b>Methods</b>: All patients undergoing AF catheter ablation between January 2015 and November 2024 were screened, and cases meeting the inclusion criteria were included. Primary outcome was defined as atrial tachycardia recurrence-free survival. <b>Results</b>: A total of 98 patients (mean age 54.2 ± 14.0 years; 55.1% male) were enrolled, with 66.3% presenting with paroxysmal atrial fibrillation (AF). The mean left atrial diameter was 38.7 ± 5.1 mm, and 78.6% underwent cryoballoon ablation. Class IC AADs were administered to 62 cases, while the remaining 36 patients received amiodarone following catheter ablation. The rate of atrial tachycardia (ATa) recurrence was comparable between the patients treated with Class IC and Class III AADs (9.7% vs. 19.4%; <i>p</i> = 0.169). Predictors of ATa recurrence were identified as history of direct current cardioversion—DCCV (HR: 5.86; 95%CI: 1.44–23.82)—and LA diameter (HR: 1.17; 95%CI: 1.04–1.31). The most frequent AAD-related adverse event was symptomatic bradycardia (6.1%), which resolved in all cases following dose reduction. <b>Conclusions</b>: Class IC and Class III antiarrhythmics show comparable efficacy in terms of preventing ATa recurrence following AF catheter ablation. AAD-related adverse event rates are negligible for short-term use.https://www.mdpi.com/1424-8247/18/7/1022antiarrhythmicsamiodaroneatrial fibrillationcatheter ablationflecainidepropafenone |
| spellingShingle | Andrej Belančić Yusuf Ziya Sener Metin Oksul Cansu Ozturk Serdar Soner Adnan Duha Comert Gamze Yeter Arslan Dinko Vitezić Bojan Jelaković Erkan Baysal Comparing the Impact of Different Antiarrhythmic Classes on Clinical Outcomes Following Atrial Fibrillation Catheter Ablation Pharmaceuticals antiarrhythmics amiodarone atrial fibrillation catheter ablation flecainide propafenone |
| title | Comparing the Impact of Different Antiarrhythmic Classes on Clinical Outcomes Following Atrial Fibrillation Catheter Ablation |
| title_full | Comparing the Impact of Different Antiarrhythmic Classes on Clinical Outcomes Following Atrial Fibrillation Catheter Ablation |
| title_fullStr | Comparing the Impact of Different Antiarrhythmic Classes on Clinical Outcomes Following Atrial Fibrillation Catheter Ablation |
| title_full_unstemmed | Comparing the Impact of Different Antiarrhythmic Classes on Clinical Outcomes Following Atrial Fibrillation Catheter Ablation |
| title_short | Comparing the Impact of Different Antiarrhythmic Classes on Clinical Outcomes Following Atrial Fibrillation Catheter Ablation |
| title_sort | comparing the impact of different antiarrhythmic classes on clinical outcomes following atrial fibrillation catheter ablation |
| topic | antiarrhythmics amiodarone atrial fibrillation catheter ablation flecainide propafenone |
| url | https://www.mdpi.com/1424-8247/18/7/1022 |
| work_keys_str_mv | AT andrejbelancic comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation AT yusufziyasener comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation AT metinoksul comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation AT cansuozturk comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation AT serdarsoner comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation AT adnanduhacomert comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation AT gamzeyeterarslan comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation AT dinkovitezic comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation AT bojanjelakovic comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation AT erkanbaysal comparingtheimpactofdifferentantiarrhythmicclassesonclinicaloutcomesfollowingatrialfibrillationcatheterablation |