Nationwide survey of catheter ablation for atrial fibrillation: The Japanese Catheter Ablation Registry of Atrial Fibrillation (J‐CARAF) – Report on antiarrhythmic drug therapy

Authors:
  • YMYuji Murakawa
    Yuji Murakawa
  • ANAkihiko Nogami
    Akihiko Nogami
  • MSMorio Shoda
    Morio Shoda
  • KIKoichi Inoue
    Koichi Inoue
  • SNShigeto Naito
    Shigeto Naito
  • KKKoichiro Kumagai
    Koichiro Kumagai
  • YMYasushi Miyauchi
    Yasushi Miyauchi
  • TYTeiichi Yamane
    Teiichi Yamane
  • NMNorishige Morita
    Norishige Morita
  • HMHideo Mitamura
    Hideo Mitamura
  • KOKen Okumura
    Ken Okumura
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Abstract
Background: The Japanese Heart Rhythm Society (JHRS) conducted a nationwide survey of catheter ablation of atrial fibrillation (AF) in Japan, the Japanese Catheter Ablation Registry of Atrial Fibrillation (J‐CARAF). In this report, to offer a perspective on the current status of hybrid AF therapy, we focus on antiarrhythmic drug (AAD) therapy before and after AF ablation.Methods: The JHRS requested electrophysiology centers in Japan to retrospectively register the comprehensive data of each AF ablation session performed in September 2011, March 2012, or September 2012.Results: A total of 179 EP centers submitted data for 3373 sessions. The average patient age was 62.2±10.6 years, and 76.1% (2587) were male. Patients with paroxysmal AF (PAF) consisted of 64.4% of total patients. The average number of AADs used before AF ablation was 1.13±0.96. Among 2173 PAF patients, 454 subjects (20.9%) underwent AF ablation without preceding AAD therapy.At the time of discharge, 40.3% of PAF patients were given one or more AAD, while 63.0% of persistent AF patients and 71.5% of long‐standing‐persistent AF patients left the hospital with an AAD (pp<0.0001). Amiodarone was used in 5.8% of the patients. Among 148 subjects (4.5%) treated with multiple AADs, 131 were taking bepridil.Conclusions: Approximately 20% of PAF ablations were performed without preceding AAD therapy. The post‐procedural AAD regimen was appreciably dependent on the AF type.

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