Cochrane · systematic review · CD013765
Oral Class I and III antiarrhythmic drugs for maintaining sinus rhythm after catheter ablation of atrial fibrillation
Bray, JJH, Warraich, M, Whitfield, MG, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
HeartAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
7
No studies
10
Included studies
NR
No studies 10 · 41.7%Ungraded 7 · 29.2%Very low 3 · 12.5%Low 3 · 12.5%Moderate 1 · 4.2%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Class I and/or III antiarrhythmics versus control for maintaining sinus rhythm after catheter ablation of atrial fibrillation
Population: Human trial participants undergoing ablation for atrial fibrillation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes at > 3 to 6 months after ablation Class I and/or III antiarrhythmics vs control | no estimate extracted | NR | No studies |
Recurrence of atrial tachyarrhythmias Class I and/or III antiarrhythmics vs control | RR 0.85 [0.78, 0.93] | 5 studies · 2591 participants | Moderate Downgraded: risk of bias |
Adverse events: thromboembolic events Class I and/or III antiarrhythmics vs control | Peto OR 0.96 [0.06, 15.5] | 1 study · 212 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events: myocardial infarction Class I and/or III antiarrhythmics vs control | no estimate extracted | 3 participants | Ungraded |
Adverse events: new diagnosis of heart failure Class I and/or III antiarrhythmics vs control | no estimate extracted | NR | No studies |
Adverse events: requirement for 1 or more hospitalisations for atrial tachyarrhythmia Class I and/or III antiarrhythmics vs control | no estimate extracted | 3 participants | Ungraded |
All‐cause mortality Class I and/or III antiarrhythmics vs control | Peto OR 1 [0.06, 16.24] | 1 study · 90 participants | Low Downgraded: risk of bias, imprecision |
Requirement for 1 or more repeat ablations Class I and/or III antiarrhythmics vs control | no estimate extracted | 3 participants | Ungraded |
Class I antiarrhythmics versus control for maintaining sinus rhythm after catheter ablation of atrial fibrillation
Population: Human trial participants undergoing ablation for atrial fibrillation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes at > 3 to 6 months after ablation Class I antiarrhythmics vs control | no estimate extracted | NR | No studies |
Recurrence of atrial tachyarrhythmias Class I antiarrhythmics vs control | RR 0.54 [0.25, 1.19] | 1 study · 125 participants | Low Downgraded: imprecision |
Adverse events: thromboembolic events Class I antiarrhythmics vs control | no estimate extracted | NR | No studies |
Adverse events: myocardial infarction Class I antiarrhythmics vs control | no estimate extracted | NR | No studies |
Adverse events: new diagnosis of heart failure Class I antiarrhythmics vs control | no estimate extracted | NR | No studies |
Adverse events: requirement for 1 or more hospitalisations for atrial tachyarrhythmia Class I antiarrhythmics vs control | no estimate extracted | 3 participants | Ungraded |
All‐cause mortality Class I antiarrhythmics vs control | no estimate extracted | NR | No studies |
Requirement for 1 or more repeat ablation Class I antiarrhythmics vs control | no estimate extracted | 3 participants | Ungraded |
Class III antiarrhythmics versus control for maintaining sinus rhythm after catheter ablation of atrial fibrillation
Population: Human trial participants undergoing ablation for atrial fibrillation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes at > 3 to 6 months after ablation Class III antiarrhythmics vs control | no estimate extracted | NR | No studies |
Recurrence of atrial tachyarrhythmias Class III antiarrhythmics vs control | RR 0.82 [0.62, 1.09] | 2 studies · 318 participants | Low Downgraded: risk of bias, imprecision |
Adverse events: thromboembolic events Class III antiarrhythmics vs control | Peto OR 0.96 [0.06, 15.5] | 1 study · 212 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events: myocardial infarction Class III antiarrhythmics vs control | no estimate extracted | NR | No studies |
Adverse events: new diagnosis of heart failure Class III antiarrhythmics vs control | no estimate extracted | NR | No studies |
Adverse events: requirement for 1 or more hospitalisations for atrial tachyarrhythmia Class III antiarrhythmics vs control | no estimate extracted | 3 participants | Ungraded |
All‐cause mortality Class III antiarrhythmics vs control | Peto OR 0.13 [0, 6.57] | 1 study · 212 participants | Very low Downgraded: risk of bias, imprecision |
Requirement for 1 or more repeat ablation Class III antiarrhythmics vs control | no estimate extracted | 3 participants | Ungraded |