Prevention of atrial tachyarrhythmia in post-operation period of pulmonary veins ostia catheter isolation in paroxysmal atrial fibrillation

Aim. To study a complex approach in observation and medication
monotherapy with assessment of its effectiveness and safety, with the following antiarrhythmic drugs (AAD): IC class propafenon, III class sotalol, IV class verapamil, — comparing to the controls without AAD, for prevention of atrial fibrillation (AF) recurrent, as atrial tachyarrhythmia (AT) in postoperation period of catheter isolation of the pulmonary veins ostia (PV).

Material and methods. The study PRUF is prospective, comparison, open-label, randomized, with control group. Males and females included, at the age ≥25 y., having symptomatic paroxysmal AF without organic pathology of the heart. 243 patients were randomized to 4 groups according the drugs studied and invasive management group with achieved successful isolation of the PV ostia, confirmed during operation. There were no significant differences in baseline characteristics: sex, age, duration of AF, main disease and comorbidities, echocardiography parameters and concomitant therapy. Follow-up lasted for 365 days.

Results. PRUF study provided the following results: in group 1 (verapamil) effectiveness after first operation was 65,5% (n=40), in group 2 (propafenon) — 70,96% (n=44), in group 3 (sotalol) — 65% (n=39) and the controls (no AAD) — 65% (n=39), respectively. Main results of the study will be presented in further publications.

Conclusion. First time, the assessment of efficacy and safety provided, of different AAD classes for prevention of AF and AT episodes in earlier and later post-operation periods of catheter PV ostia, with implanted subcutaneous cardio monitor for symptomatic and asymptomatic AT, and traditional 24-hour monitoring system by Holter.

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