Effect of periprocedural amiodarone on procedure outcome in patients with longstanding persistent atrial fibrillation undergoing extended pulmonary vein antrum isolation: Results from a randomized study (SPECULATE)

Sanghamitra Mohanty, Luigi Di Biase, Prasant Mohanty, Chintan Trivedi, Pasquale Santangeli, Rong Bai, John David Burkhardt, Joseph G. Gallinghouse, Rodney Horton, Javier E. Sanchez, Patrick M. Hranitzky, Jason Zagrodzky, Amin Al-Ahmad, Gemma Pelargonio, Dhanunjay Lakkireddy, Madhu Reddy, Giovanni Forleo, Antonio Rossillo, Sakis Themistoclakis, Richard HongoSalzwa Beheiry, Michela Casella, Antonio Dello Russo, Claudio Tondo, Andrea Natale

Research output: Contribution to journalArticle

Abstract

Background The impact of amiodarone on ablation outcome in longstanding persistent atrial fibrillation (LSPAF) patients is not known yet. Objective The purpose of this study was to assess the effect of amiodarone on procedural-outcomes in LSPAF patients undergoing catheter ablation. Methods We enrolled 112 LSPAF patients on amiodarone and scheduled to undergo atrial fibrillation (AF) ablation. Patients were randomized to amiodarone discontinuation 4 months before ablation (group 1, n = 56) and a control group (group 2, n = 56) in which ablation was performed without amiodarone discontinuation. All patients underwent pulmonary vein (PV) antrum and posterior wall isolation, defragmentation and extra PV triggers ablation. Patients were followed up for recurrence for 32 ± 8 months post-ablation. Repeat procedures in all recurrent patients were performed off amiodarone. Results During ablation, AF termination was more frequent in group 2 compared to group 1 [44 (79%) vs 32 (57%), P =.015]. After high-dosage isoproterenol, more non-PV triggers were disclosed in group 1 compared to group 2 (42 [75%] vs 24 [43%] respectively, P

Original languageEnglish
Pages (from-to)477-483
Number of pages7
JournalHeart Rhythm
Volume12
Issue number3
DOIs
Publication statusPublished - Mar 1 2015

Keywords

  • Amiodarone
  • Catheterablation
  • Longstanding persistentatrial fibrillation
  • Nonpulmonary veintrigger
  • Recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

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