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AMIO-CAT: Amiodarone improved short-term recovery after AF ablation
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BARCELONA, Spain — Patients undergoing radiofrequency ablation to treat atrial fibrillation had better early outcomes if they received amiodarone immediately after their procedure, according to new data from the AMIO-CAT trial.
This is the first randomized, double blind trial to evaluate a short-term course of amiodarone after AF ablation and show that early recurrence of arrhythmia could be reduced with medication within the first 3 months after ablation, Stine Darkner, MD, from the Heart Center at Rigshospitalet in Copenhagen, Denmark, said at ESC Congress.
However, the benefit of short-term amiodarone did not persist beyond 3 months.
AMIO-CAT included 212 patients undergoing radiofrequency ablation for paroxysmal or persistent AF who were randomly assigned to 8 weeks of amiodarone (n=108) or placebo (n=104) starting immediately after the procedure. The primary endpoint was AF lasting more than 30 seconds after the blanking period.
At 6 months, Darkner reports no significant difference in AF recurrence between the amiodarone and placebo groups (39% vs. 48%, respectively; P=.18). During the blanking period, however, amiodarone reduced the number of AF recurrences compared with placebo (34% vs. 53%; P=.006) and reduced by half the number of arrhythmia-related hospitalizations (P=.006) and cardioversion rates (P=.0004).
The researchers also studied the treatment effect by type of AF. During the blanking period, amiodarone prolonged the time to first AF recurrence compared with placebo in patients with paroxysmal (P=.045) and persistent AF (P=.005). Amiodarone was associated with significantly reduced rates of hospitalization and cardioversion within the blanking period in the subgroup of patients with persistent AF.
The treatment groups did not differ significantly in the number of serious adverse events; however, significantly more patients in the amiodarone group experienced transient adverse events, including sleep disturbances, gastrointestinal symptoms and changes in serum concentrations of thyroid hormone. Patients assigned amiodarone did not report reduced quality of life compared with placebo, Darkner said.
“Short-term amiodarone is not standard treatment after ablation, but should be considered in patients with longer episodes of AF,” she said during a press conference.
For more information:
Darkner S. Hot Line V. Coronary Artery Disease and Atrial Fibrillation. Presented at: the European Society of Cardiology Congress; Aug. 30-Sept. 3, 2014; Barcelona, Spain.
Disclosure: The study was funded by the Danish Heart Foundation and The Heart Center Research Committee at Righospitalet, Copenhagen. Darkner reports no relevant financial disclosures.