Health & Medical Health & Medicine Journal & Academic

Arrhythmia Recurrence After Amiodarone Post AF Ablation

Arrhythmia Recurrence After Amiodarone Post AF Ablation

Limitations


As we did not perform continuous ECG monitoring but only performed planned 12 lead ECGs, 3-day Holter-monitorings, and otherwise symptom-driven cardiac rhythm monitoring, we could have missed some asymptomatic recurrences. The ablation technique was not completely uniform between the two ablation centres but since patients were stratified according to centre when randomized, it is unlikely that this would have influenced the findings between the two treatment groups. In addition, this might be more representative for every-day life in larger specialized clinics where different ablations techniques are used.

The power calculation and sample size were based on a 50% reduction of recurrence rate. Hence, a lower reduction of recurrence rate at 6 months might not be detected in this study. This decision was made with the potential side effects of amiodarone in mind.

Only 16% of the referred patients were randomized in the trial, which makes it a rather selected population. A follow-up of 6 months is relatively short and one could also argue that since amiodarone has long half-life, a lingering antiarrhythmic effect could persist beyond the blanking period and reduce recurrence at 6 months in the amiodarone group; however, since we found no statistically significant difference in recurrence at 6 months, it is unlikely that this would be any different at the 12-month follow-up.

Subgroup analyses of the primary end-point based on the type of AF (paroxysmal/persistent) and whether patients were treated with PVI only or PVI plus additional ablations might have been interesting. The latter comparison might even more accurately reflect the extent of electroanatomical remodelling of the left atria, thus provide better information on mechanisms and possible treatment success of the ablation than the clinical term paroxysmal/persistent. However, in the present setting, such subgroup analysis would be statistically underpowered and were not performed due to the risk of false-negative findings.

SHARE
RELATED POSTS on "Health & Medical"
Pharmacy Students' Interpretation of Academic Integrity
Pharmacy Students' Interpretation of Academic Integrity
Topical Insect Repellents in Endemic Malaria Populations
Topical Insect Repellents in Endemic Malaria Populations
Silica Exposure and Lung Cancer Risk
Silica Exposure and Lung Cancer Risk
Marathon Run: Cardiovascular Adaptation and CV Risk
Marathon Run: Cardiovascular Adaptation and CV Risk
First Human Robotic Tracheal Intubations
First Human Robotic Tracheal Intubations
Atrial Fibrillation Guidelines Across the Atlantic
Atrial Fibrillation Guidelines Across the Atlantic
Cardiovascular Disease in Pregnancy
Cardiovascular Disease in Pregnancy
Evolution of Self-care Education
Evolution of Self-care Education
Blastoschizomyces Capitatus Pneumonia in an Immunocompetent Male
Blastoschizomyces Capitatus Pneumonia in an Immunocompetent Male
Primaquine Radical Cure of Plasmodium Vivax
Primaquine Radical Cure of Plasmodium Vivax
Introduction of Handheld Computing
Introduction of Handheld Computing
Comparison of Anticoagulation Clinic Patient Outcomes
Comparison of Anticoagulation Clinic Patient Outcomes
Traditional Anticoagulant Therapy
Traditional Anticoagulant Therapy
Smad4 Status and 5-FU-Based Treatment in Colorectal Cancer
Smad4 Status and 5-FU-Based Treatment in Colorectal Cancer
Atrial Fibrillation in Stroke-Free Patients and Memory Impairment
Atrial Fibrillation in Stroke-Free Patients and Memory Impairment
Current Perspectives in Bladder Cancer Management
Current Perspectives in Bladder Cancer Management
The Genius of Sabina Spielrein
The Genius of Sabina Spielrein
Surgical Safety Checklists
Surgical Safety Checklists
Acute Renal Failure as a Presentation of Sarcoidosis
Acute Renal Failure as a Presentation of Sarcoidosis
Coronary Revascularization in Diabetic Patients
Coronary Revascularization in Diabetic Patients
Insomnia as a Predictor of High-Lethality Suicide Attempts
Insomnia as a Predictor of High-Lethality Suicide Attempts
Advanced Parental Age and the Risk of Autism Spectrum Disorder
Advanced Parental Age and the Risk of Autism Spectrum Disorder

Leave Your Reply

*