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.