International Circulation:  Should anti-arrhythmic drugs be used routinely in persistent atrial fibrillation patients to maintain sinus rhythm after successful procedure of catheter ablation? How long should these drugs be used?

　　《国际循环》：对成功消融的持续性心房颤动患者，是否需要常规使用抗心律失常药物以维持窦性心律?疗程是多久?

　　John Day: The 5A study was recently published where they compared anti-arrhythmics to placebo for 6 weeks following catheter ablation. They saw that with anti-arrhythmics they were able to improve the 6-month outcome by decreasing atrial fibrillation， hospitalizations， and cardioversions. In our experience we will typically use anti-arrhythmics for about 3 months after the procedure. If the patient is doing well and maintaining sinus rhythm， we will then discontinue the anti-arrhythmics at the 3-month mark. We find that it is quite effective. If nothing else， patients are happier because they are not having early recurrences of atrial fibrillation.

　　International Circulation:  In your study how long is the follow-up period?

　　John Day:  We have followed thousands of patients for multiple years. Our mean follow-up is for one year but we do have patients that we have followed for more than 5 years. We try to get patients off anti-arrhythmics at 3 months. If they have a recurrence of atrial fibrillation， we will then offer them the possibility of going back on anti-arrhythmics or having a second ablation procedure. We try to minimize the use of anti-arrhythmics because these drugs may have toxicities. We generally will treat for three month before stopping.

　　John Day教授: 5A研究最近发表了研究结果，该试验在导管消融术后应用6周抗心律失常药物或安慰剂，结果发现抗心律失常药物通过减少房颤、住院和心脏复律，能够改善6个月时的预后。我们中心的经验是会在导管消融术后常规使用抗心律失常药物大约3个月。如果患者状态良好，维持窦性心律，我们就在3个月后停用抗心律失常药。我们发现这种策略非常有效，至少患者也比较高兴，因为他们没有房颤的早期复发。我们已经随访上千名患者许多年了，随访期一般为一年，但是有些患者我们已经随访5年以上。如果患者有房颤的复发，我们就会让他们重新服用抗心律失常药物治疗或者二次消融。总之，我们尽量让患者在消融术后3个月停止抗心律失常药物，把抗心律失常药物的应用控制在最低程度，因为这些药物毒性大。