Abstract 12487: Antiarrhythmic Medication Discontinuation After Ablation of Atrial Fibrillation

Abstract

Introduction: Antiarrhythmic medications are often needed after atrial fibrillation (AF) ablation but may induce side effects (e.g., nausea, fatigue) or new arrhythmias. Knowing the length of time antiarrhythmics may be needed post-ablation is important for patients evaluating benefits and risks of ablation. The purpose of this study was to evaluate the prevalence of antiarrhythmic discontinuation following AF ablation and analyze associations between demographic variables and discontinuation. Methods: We extracted institutional electronic health record (EHR) data for patients who underwent ablation 2010-2019, identified with billing codes. Using medication administration data, we assessed documentation of five common oral antiarrhythmics: amiodarone, flecainide, dronedarone, propafenone, and dofetilide at baseline (within 2 weeks before and after ablation) 2-24 weeks post-ablation, and >24 weeks post-ablation. We calculated standard descriptive statistics and examined differences by age, gender, and race using Chi-square tests. Results: Patients (n=1180) had an average age of 64.9 (±12.1) years; 33% were female, and 74% were White. Most (61.2%) had antiarrhythmics documented at baseline; of these patients, 41.8% did not have antiarrhythmics documented at all post-ablation, 21.3% had them documented 2-24 weeks post-ablation but not after, and 19.4% had them documented at both 2-24 and >24 weeks. Documentation of antiarrhythmics beyond 2 weeks post-ablation was more likely among younger patients (<65) versus older (63.3% vs. 54.2%; p=0.017) and trended towards significant for White versus non-White patients (61.4% vs. 54.5%; p=0.07). There was no significant difference by gender. Conclusion: More than half of patients had antiarrhythmics documented following AF ablation, especially younger patients.