Recurrence of arrhythmia following short-term oral AMIOdarone after CATheter ablation for atrial fibrillation: a double-blind, randomized, placebo-controlled study (AMIO-CAT trial)
Abstract
AIMS: Patients undergoing catheter ablation for atrial fibrillation (AF) often experience recurrent arrhythmias within the first few months post-ablation. We aimed to investigate whether short-term use of amiodarone to prevent early arrhythmias following radiofrequency ablation for AF could reduce later recurrence. METHODS AND RESULTS: In a two-centre, randomized, double-blind, placebo-controlled study, we randomized a total of 212 patients undergoing AF ablation. Patients were stratified according to type of AF (paroxysmal/persistent) and history of previous AF ablation and randomly assigned to 8 weeks of oral amiodarone therapy or matched placebo following catheter ablation. Patients were followed for 6 months. Analyses were performed according to the intention-to-treat principle. Of 212 enrolled patients [median age 61 (inter-quartile range 54-66), 83% male, 50% paroxysmal, 29% with history of previous ablation], 206 patients were available for analysis of the primary end-point which was any documented atrial tachyarrhythmia lasting >30 s following a blanking period of 3 months. This was observed in 42/107 (39%) in the amiodarone group vs. 48/99 (48%) in the placebo group (P = 0.18). Among the secondary end-points, the amiodarone group showed significantly lower rate of atrial tachyarrhythmia-related hospitalizations [rate ratio = 0.43; 95% confidence interval (CI) = 0.23-0.77, P = 0.006] and cardioversions (rate ratio = 0.36; 95% CI = 0.20-0.62, P = 0.0004) within the blanking period. CONCLUSION: Short-term oral amiodarone treatment following ablation for paroxysmal or persistent AF did not significantly reduce recurrence of atrial tachyarrhythmias at the 6-month follow-up, but it more than halved atrial arrhythmia related hospitalization and cardioversion rates during the blanking period.
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Amiodarone halved early AF recurrences compared with placebo in a recent controlled trial.
“amiodarone halved early AF recurrences compared with placebo.650”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [650]
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
Self-citation2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
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Self-citation
- Authors
- Darkner, S., Chen, X., Hansen, J., Pehrson, S., Johannessen, A., Nielsen, J. B., & Svendsen, J. H.
- Affiliations
- Copenhagen University Hospital (DK)
- Gentofte Hospital (DK)
- University of Copenhagen (DK)
- Corresponding author
- Darkner, S.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-09-02
- Volume
- 35
- Issue
- 47
- Pages
- 3356-3364
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2125631645
- Cited by
- 142
- References
- 19
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 13 · 2023: 8 · 2022: 5 · 2021: 11 · 2020: 13 · 2019: 15 · 2018: 9 · 2017: 8 · 2016: 21 · 2015: 16 · 2014: 5
- FWCI
- 11.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Hjerteforeningen
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- amiodarone, atrial fibrillation, catheter ablation, radiofrequency ablation, arrhythmia recurrence, atrial tachyarrhythmia, paroxysmal atrial fibrillation, persistent atrial fibrillation, cardioversion, hospitalization
- MeSH terms
- Aged, Amiodarone, Anti-Arrhythmia Agents, Atrial Fibrillation, Combined Modality Therapy, Double-Blind Method, Female, Humans, Male, Middle Aged, Recurrence, Tachycardia, Catheter Ablation
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