Prognostic value of pharmacotherapy in patients with atrial fibrillation after radiofrequency ablation

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.6.229973

Keywords:

radiofrequency ablation, atrial fibrillation, prognostic effect

Abstract

The aim of the work: to evaluate the prognostic effect of pharmacotherapy before and after radiofrequency ablation (RFA) in patients with atrial fibrillation (AF) on all-cause mortality, supraventricular arrhythmia recurrence and non-fatal cardiovascular events.

Materials and methods. Patients with paroxysmal, persistent and long-term persistent forms of AF were examined before and after RFA – isolation of pulmonary veins. The primary endpoint was patient survival, secondary – a composite endpoint of freedom from recurrence and/or non-fatal cardiovascular events for 2 years of a follow-up. Frequency and doses of pharmacotherapy were evaluated. Standard statistical procedures were used for initial data evaluation.

Results. 116 patients were consecutively enrolled in the study. In the long-term post-ablation, 23 patients (19.8 %) continued to take amiodarone, 2 patients (1.7 %) – propafenone for arrhythmic events, 38 patients (32.8 %) needed anticoagulants, and 37 patients (31.9 %) received beta-adrenoceptor blockers over the entire follow-up period. The use of RAAS inhibitors decreased from 81.0 % before the ablation to 56.0 % in the long-term period following RFA. Multifactorial logistic regression analysis showed that the prolonged (more than 3 months) anticoagulation (P = 0.032) after RFA was an independent predictor of patient survival in the two-year follow-up; doses of anticoagulants before the procedure, use and doses of beta-adrenoceptor blockers in the long-term post-ablation period were associated with the secondary endpoint.

Conclusions. RFA for AF significantly reduced the frequency of medications use in the long-term postoperatively. Independent predictors of survival were the doses of anticoagulants more than 3 months after ablation, arrhythmia recurrence and non-fatal cardiovascular events – the doses of anticoagulants before the procedure, and the use and doses of beta-adrenoceptor blockers in the long-term period after RFA.

Author Biographies

M. S. Brynza, V. N. Karazin Kharkiv National University, Ukraine

MD, PhD, Associate Professor, Head of the Department of Propaedeutics of Internal Medicine and Physical Rehabilitation

O. V. Bilchenko, V. N. Karazin Kharkiv National University, Ukraine

MD, PhD, DSc, Professor of the Department of Internal Medicine

O. S. Makharynska, V. N. Karazin Kharkiv National University, Ukraine

 MD, PhD, Associate Professor of the Department of Propaedeutics of Internal Medicine and Physical Rehabilitation

M. I. Shevchuk, V. N. Karazin Kharkiv National University, Ukraine

MD, PhD, Associate Professor of the Internal Medicine Department

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Published

2021-10-29

How to Cite

1.
Brynza MS, Bilchenko OV, Makharynska OS, Shevchuk MI. Prognostic value of pharmacotherapy in patients with atrial fibrillation after radiofrequency ablation. Zaporozhye Medical Journal [Internet]. 2021Oct.29 [cited 2024Oct.16];23(6):772-7. Available from: http://zmj.zsmu.edu.ua/article/view/229973

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Original research