Effect of Beta-Blocker Therapy on Recurrence after Extensive Encircling Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation

Background: Effect of beta-blocker on paroxysmal atrial fibrillation (PAF) recurrence after extensive encircling pulmonary vein isolation (EEPVI) remains unknown. It has been known to be common that PAF recurs within 3 months after EEPVI, named blanking period, even in patients in whom PAF never recur thereafter. Methods and Results: This study evaluated consecutive 39 patients (34 male Age 57±11 y/o) who underwent EEPVI for PAF. Out of 39 patients, 15 patients (38%) underwent beta-blocker therapy (mainly bisoprolol 2.5–5 mg/day) shortly after EEPVI with/without same anti-arrhythmic drugs (AAD) as prescribed before EEPVI (Group A) and the remaining patients did not beta-blocker therapy but with/without same AAD as prescribed before EEPVI (Group B). Such a drug treatment in each group remained until 24 months after EEPVI. Patient characteristics including cardiac structural parameters and treatment period of PAF before EEPVI did not differ between Groups (NS). During follow-up of blanking period, PAF recurred in 11 patients (73%) in Group A and 7 patients (29%) in Group B (NS). During further follow-ups (15±5 months) except for blanking period, AF recurred in 7 patients (47%) with Group A and 6 patients (25%) in Group B (NS). Conclusion: This study may suggest that an additional effect of beta-blocker therapy against PAF recurrence has not significant importance for both short and long term follow-ups after EEPVI.