The high early recurrence (ER) rate after radiofrequency catheter ablation (RFCA)
seriously affects the prognosis of patients with atrial fibrillation (AF), and there
are still controversies regarding the best preventive drugs for postoperative recurrence.
A single-center retrospective study was conducted on patients with paroxysmal atrial
fibrillation (PAF) who received metoprolol sustained-release tablets combined with
dronedarone (observation group) and dronedarone alone (control group) after the first
RFCA. A matching cohort was established using a 1:1 propensity score matching method
to compare the incidence of ER, cardiac function, inflammation level, quality of life
(QoL), and antiarrhythmic drugs (AADs)-related adverse reactions between groups. A
total of 56 pairs of patients were successfully matched. The incidence of ER in the
observation group was significantly lower than that in the control group (32% vs 14%,
p = 0.033); the left atrial diameter in the observation group was significantly lower
than that in the control group on Day 90 after RFCA (38 ±4 vs 40 ± 5, p = 0.021),
and the QoL of the observation group was significantly improved on the thirtieth and
ninetieth days after RFCA compared with the control group (72 ± 5 vs 69 ± 9, p = 0.031;
73 ± 4 vs 70 ± 9, p = 0.025). Multifactorial Cox analysis showed that diabetes mellitus,
left atrial diameter >45 mm, ventricular rate >110 beats/min, and postoperative AADs
were independent risk factors for ER in patients with PAF. The incidence of sinus
bradycardia in the observation group was significantly higher than that in the control
group (18% vs 3.6%, p = 0.029), but there was no statistical difference in the overall
incidence of AADs-related adverse reactions between groups. Compared with dronedarone
alone, dronedarone combined with metoprolol sustained-release tablets can significantly
reduce ER after RFCA in patients with PAF and improve cardiac function and QoL, without
increasing the AADs-related adverse reactions.
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Article info
Publication history
Published online: October 15, 2022
Received in revised form:
August 9,
2022
Received:
July 4,
2022
Footnotes
Pei Wang and Dongdong Yan contributed equally to this manuscript.
Funding: This study was supported by the National Key Research and Development Program of China (Lanzhou, China) grant no. 2,018YFC131,1505 and the Cardiovascular Clinical research center of Gansu Province (Lanzhou, China) grant no.18JR2FA005.
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