Pharmacological Prevention of Paroxysmal Fibrillatory Episodes in 2D Atria Considering Atrial Dominant Frequency

The suboptimal success of antiarrhythmic drugs (AADs) in preventing paroxysmal Atrial Fibrillation (pAF) episodes could potentially be addressed by considering how intersubject variability influences the response to the pharmacological treatment choice.This study investigates the impact of the AF dominant frequency (DF) during medication-free periods on the efficacy of two AADs (flecainide and vernakalant) in preventing pAF episodes using 2D pAF left atrial models.Both effectively reduced the vulnerable window (VWwidth) at low drug-free DF, with vernakalant exhibiting greater efficacy than flecainide.At high drug-free DF, the drugs differed in efficacy such that vernakalant showed a better reduction in VWwidth, while flecainide caused slight increments.These findings suggest that the drug efficacy in preventing pAF episodes is influenced by drug-free DF, highlighting the potential to enhance personalized pharmacological strategies in pAF patients.