The efficacy of antiarrhythmic therapy in the early postoperative period of catheter isolation of the mouths of the pulmonary veins for the treatment of paroxysmal atrial fibrillation

Goal. Explore a comprehensive approach in monitoring and drug monotherapy with the evaluation of its effectiveness and safety of the following antiarrhythmic drugs (AAD): IC class - propafenone, III class - sotalol and class IV - verapamil, compared with the control group without the AAD, for the prevention of recurrence of atrial fibrillation (AF) and atrial tachyarrhythmias in the postoperative catheter isolation of the mouths of the pulmonary veins (PV). Material and methods. PRMF study (Prevention of recurrence of atrial tachyarrhythmias in the postoperative catheter wellhead isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation) is a prospective, comparative, open, randomized with a control group. Included in the study of men and women aged 25 years and over who suffer from symptomatic paroxysmal AF without structural heart disease. 243 patients (after invasive treatment to achieve electrical isolation mouth LP, confirmed during the operation) were randomized by envelope into 4 groups and control group. No significant differences in baseline characteristics: age, sex, duration of AF, the basic or comorbidities, echocardiography parameters and concomitant therapy, there were no between-group. Patients were 365 days. Results. The following results were obtained in the PRMF study: in group 1 (verapamil) effectiveness after 1st surgery was 65.5% (n=40) in group 2 (propafenone) - 70.96% (n=44) in group 3 (sotalol) - 65% (n=39) and control group (no AAD) - 65% (n= 39), respectively. During 3 months of follow up in all groups was carried out by an average 11.52±10.905 cardioversions medication (n=243), an average of 0.839±1.44 electrical cardioversion and the average number of hospitalizations for 3 months follow-up was 0.654±0.74 cases. Conclusion. Antiarrhythmic therapy in the postoperative period of radiofrequency ablation (RFA), the mouth of the LP does not affect the outcome of invasive therapy and repeated surgical intervention. 22% of patients have clinical efficacy. From AAD study significantly influenced the clinical course of early postoperative period of RFA mouth LP - only propafenone, reducing the average number of electrical cardioversion, pharmacological cardioversions and the number of hospitalizations associated with recurrent arrhythmias. Sotalol significantly reduced the mean number of hospitalizations, without lowering medication and electrical cardioversion in the early postoperative period of invasive treatment of AF.

atrial fibrillation, radiofrequency ablation of the mouth of the pulmonary veins, the early postoperative period, antiarrhythmic therapy, verapamil, propafenone, sotalol