Effect of Prolonged Use of Dronedarone on Recurrence in Patients with Non-Paroxysmal Atrial Fibrillation After Radiofrequency Ablation (DORIS): Rationale and Design of a Randomized Multicenter, Double-Blinded Placebo-Controlled Trial.

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiovascular Drugs and Therapy Pub Date : 2024-10-01 Epub Date: 2023-05-08 DOI:10.1007/s10557-023-07460-1
Yizhang Wu, Fenghua Fan, Jinbo Yu, Jian Zhou, Xin Xie, Guang Xia, Dongxiang Zhong, Dian Cheng, Baowei Zhang, Xuecheng Wang, Zijun Chen, Shuo Wang, Xiaorong Li, Bing Yang
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引用次数: 0

Abstract

Background: Prolonged use of anti-arrhythmic drugs (AAD) beyond the post-ablation blanking period to maintain sinus rhythm has been adopted in clinical practice but without sufficient evidence. Dronedarone is an AAD valid for maintaining sinus rhythm with fewer side effects than other AAD for long-term use.

Objective: We sought to investigate the effect of prolonged use of dronedarone on the recurrence of non-paroxysmal AF patients beyond 3 months within the first year after ablation.

Methods: Non-paroxysmal AF patients will receive dronedarone for 3 months after radiofrequency ablation. Patients without drug side effects and atrial tachyarrhythmia (AT) recurrence will then be randomly divided into dronedarone and placebo groups and followed up until 1 year after ablation. The primary endpoint is the cumulative nonrecurrence rate post 3 months to 1 year after ablation. Patients will receive 7-day Holter monitoring (ECG patch) at 6, 9, and 12 months after ablation to evaluate AT recurrence. Secondary endpoints include dronedarone withdrawal due to side effects or intolerance of AT recurrence, time to the first recurrence, repeat ablation, electrical cardioversion, unscheduled emergency room visit, or re-hospitalization.

Conclusion: This trial will evaluate whether prolonged use of dronedarone effectively reduces the recurrence rate after ablation in non-paroxysmal AF patients. The result of this trial will provide evidence for optimizing post-ablation anti-arrhythmic therapy.

Trial registration: ClinicalTrials.gov ; NCT05655468, 19-December-2022.

长期使用决奈达隆对射频消融术后非阵发性房颤患者复发的影响(DORIS):多中心双盲安慰剂对照随机试验的原理与设计》。
背景:在消融术后的空白期之后长期使用抗心律失常药物(AAD)以维持窦性心律已在临床实践中被采用,但没有足够的证据。决奈达隆是一种可维持窦性心律的抗心律失常药物,与其他抗心律失常药物相比,长期使用的副作用较少:我们试图研究长期使用决奈达隆对非阵发性房颤患者在消融术后第一年内超过 3 个月后复发的影响:非阵发性房颤患者将在射频消融术后接受决奈达隆治疗3个月。然后将没有药物副作用和房性快速性心律失常(AT)复发的患者随机分为决奈达隆和安慰剂两组,并随访至消融术后 1 年。主要终点是消融术后 3 个月至 1 年的累积不复发率。患者将在消融术后 6、9 和 12 个月接受 7 天 Holter 监测(心电图贴片),以评估 AT 复发情况。次要终点包括因副作用或不耐受AT复发而停用决奈达隆、首次复发时间、重复消融、心脏电复律、计划外急诊就诊或再次住院:这项试验将评估长期使用决奈达隆是否能有效降低非阵发性房颤患者消融术后的复发率。该试验的结果将为优化消融术后抗心律失常治疗提供证据:试验注册:ClinicalTrials.gov ; NCT05655468,2022 年 12 月 19 日。
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来源期刊
Cardiovascular Drugs and Therapy
Cardiovascular Drugs and Therapy 医学-心血管系统
CiteScore
8.30
自引率
0.00%
发文量
110
审稿时长
4.5 months
期刊介绍: Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.
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