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Introduction The Early Treatment of Atrial Fibrillation for Stroke Prevention Trial (EAST-AFNET), published in 2020, reported a significant reduction in cardiovascular (CV) death and stroke in patients receiving early atrial fibrillation (AF) rhythm control, of which only 8% were assigned to catheter ablation. No population-based studies looking at anti arrhythmic drug (AAD) prescription rates have been studied past 2018.Objective To determine the impact of the EAST-AFNET trial on AAD claim rates in Ireland.Methods Data on AAD claims were obtained from 1st January 2014 to 31st December 2023 using Primary Care Reimbursement Services national pharmacy claims databases. AADs were identified using WHO ATC codes and included flecainide, propafenone, amiodarone, dronedarone and sotalol ( figure 1). To determine the claim rate, data is presented as total number of patients/1000 population. An interrupted time series analysis was carried out to identify the impact of the EAST-AFNET trial publication on the rate of AAD claims.Results A significant increase in total annual AAD claims were seen after the publication of EAST-AFNET (β = 0.957, p = 0.025, 95%CI [0.03 – 0.34]). This was driven by significant increments in flecainide and propafenone (β = 0.418, p = 0.012, 95%CI [0.012–0.017] and β = 1.813, p = 0.001, 95%CI [0.013 – 0.033] respectively). Amiodarone claims, which were declining pre 2021 also saw a significant increase (β = 1.269, p = 0.003, 95%CI [0.042 – 0.128]). No significant change in sotalol and dronedarone claims were seen (β = 0.322, p = 0.463, 95%CI [-0.44 – 0.86] and (β = 0.174, p = 0.69, 95%CI [-0.19 – 0.26]).Conclusion The rate of total AAD claims increased significantly after the publication of EAST-AFNET. This was driven by significant increases in flecainide, propafenone and amiodarone, with no change seen in sotalol and dronedarone claims.Abstract 14 Figure 1