[Effectiveness of D,L-sotalol in post-ablative atrial arrhythmias in patients with atrial fibrillation treated with radiofrequency ablation]

Attila Mihálcz, Csaba Földesi, Attila Kardos, Károly Ladunga, Tamás Szili-Török
Orvosi Hetilap 2009 September 6, 150 (36): 1694-700

UNLABELLED: Left atrial tachycardia is the most common arrhythmia developing after pulmonary vein (PV) isolation in patients with atrial fibrillation.

AIM: To compare the clinical effectiveness of class Ic propafenone and class III D,L sotalol in antiarrhythmic treatment of post-ablation left atrial tachycardias.

METHODS AND RESULTS: A total of 75 consecutive patients with an age of 55.4 +/- 7.14 (mean +/- SD) years underwent real electrical isolation of the pulmonary veins. Beside electroanatomical guidance, a circular mapping catheter was used to achieve total electrical disconnection of the pulmonary veins from left atrium at the antrum level. After procedure, the antiarrhythmic drug therapy was continued with the tendency to taper down during follow up visits. These were scheduled 1 and later 3 monthly after PV isolation. After the first 3 months follow-up period, left atrial tachycardia occurred in 21 patients (31.3 %). 11 of them were on propafenone therapy, 6 were on sotalol therapy and 4 patients with left atrial tachycardia received amiodarone. In the first and third group, after developing left atrial tachycardia, the 1C class drug or amiodarone was changed to III D,L sotalol. In the second group, after developing left atrial tachycardia, the III D,L sotalol was changed to 1C class drug. 9 months later, in III D,L sotalol treated group of left atrial tachycardia patients (15), the drug was considered effective in 12 patients.

CONCLUSION: In prevention of left atrial tachycardia occurred after PV isolation, sotalol is not more effective than 1C class propafenone. Otherwise, III D,L sotalol seems to be effective in anti-arrhythmic treatment of developed post-ablation in late left atrial tachycardias.

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