Effect of Restoration of Sinus Rhythm by Extensive Antiarrhythmic Drugs in Predicting Results of Catheter Ablation of Persistent Atrial Fibrillation

In patients with persistent atrial fibrillation (AF), an extensive antiarrhythmic drug (AAD) therapy using class III AADs and class I AADs might be more effective in restoring sinus rhythm than class I or III AADs alone. However, the significance and efficacy of this treatment before radiofrequency catheter ablation is unclear. The present study included 51 consecutive patients with long-lasting persistent AF (>12 months) in whom ≥2 previous AADs had failed to restore sinus rhythm (SR). Before performing extensive pulmonary vein isolation, extensive AAD therapy for >3 months was attempted. Before ablation, AF had converted to SR in 33 patients (65%; SR group) and had continued in 18 (35%; AF group). The left ventricular ejection fraction had increased (p