| Summary: | Background: The Japanese Heart Rhythm Society (JHRS) conducted a nationwide survey of catheter ablation of atrial fibrillation (AF) in Japan, the Japanese Catheter Ablation Registry of Atrial Fibrillation (J-CARAF). In this report, to offer a perspective on the current status of hybrid AF therapy, we focus on antiarrhythmic drug (AAD) therapy before and after AF ablation.
Methods: The JHRS requested electrophysiology centers in Japan to retrospectively register the comprehensive data of each AF ablation session performed in September 2011, March 2012, or September 2012.
Results: A total of 179 EP centers submitted data for 3373 sessions. The average patient age was 62.2±10.6 years, and 76.1% (2587) were male. Patients with paroxysmal AF (PAF) consisted of 64.4% of total patients. The average number of AADs used before AF ablation was 1.13±0.96. Among 2173 PAF patients, 454 subjects (20.9%) underwent AF ablation without preceding AAD therapy.
At the time of discharge, 40.3% of PAF patients were given one or more AAD, while 63.0% of persistent AF patients and 71.5% of long-standing-persistent AF patients left the hospital with an AAD (p<0.0001). Bepridil was most frequently prescribed (17.4%), specifically in non-PAF patients (PAF 10.5% vs. non-PAF 30.3%, p<0.0001). Amiodarone was used in 5.8% of the patients. Among 148 subjects (4.5%) treated with multiple AADs, 131 were taking bepridil.
Conclusions: Approximately 20% of PAF ablations were performed without preceding AAD therapy. The post-procedural AAD regimen was appreciably dependent on the AF type.
|
|---|