Concomitant use of AADs after CA
Some reports have demonstrated the benefit of the concomitant use of AADs after CA. A previous randomized controlled trial in patients with paroxysmal AF showed that the continued use of AADs beyond the blanking period after CA significantly reduced the incidence of recurrent AF.17 A retrospective cohort study reported that the concomitant use of bepridil was particularly useful for suppressing AF after CA.18 However, data on the duration of AADs combined with CA for AF are still limited. In the EAST-AF and AMIO-CAT trials, the use of AADs limited to the blanking period after CA did not reduce the overall rate of recurrent AF during long-term follow-up.19,20 To our knowledge, this is the first report comparing the effects of the short-term and long-term use of bepridil after CA for persistent AF. In our cohort, the duration of bepridil administration did not affect the outcome after bepridil discontinuation. Notably, most cases of recurrent AF in the long-term continuation group occurred within a few months of bepridil discontinuation, suggesting that bepridil significantly contributed to the maintenance of sinus rhythm, but did not have a carryover effect after discontinuation in these patients.