Impact of Colchicine Monotherapy on the Risk of Acute Pericarditis Following Atrial Fibrillation Ablation.

Abstract

BACKGROUND:

Acute pericarditis is a known complication of ablation procedures for atrial fibrillation (AF).

OBJECTIVES:

This study aimed to evaluate the benefits of colchicine monotherapy in terms of reducing the risk of pericarditis and related hospitalization rate in AF patients undergoing catheter ablation.

METHODS:

Consecutive AF patients undergoing first catheter ablation were classified into 3 groups based on their colchicine use: Group 1: no colchicine; group 2: colchicine from 7 days before to 1 month after ablation; and group 3: colchicine from the day of the procedure to 1 month after. Standard institutional protocol was used to follow all patients for 1 year.

RESULTS:

A total of 1,075 patients were classified into groups 1 (n = 607), 2 (n = 213), and 3 (n = 255). Symptoms of acute pericarditis were reported in 129 patients (12%): group 1: n = 106 (17.5%); group 2: n = 4 (1.9%); and group 3: n = 19 (7.5%); P < 0.001. Rate of mild-moderate as well as severe pericarditis were significantly lower in group 2. In the multivariable regression analysis, pre- and post-ablation colchicine use was seen to be associated with significantly lower risk of acute pericarditis and related hospitalization compared with the other 2 groups. In addition, at 1-year follow-up, arrhythmia-free survival rate was significantly higher in paroxysmal AF patients receiving colchicine compared with the no-colchicine population.

CONCLUSIONS:

Colchicine therapy starting 7 days before to 1 month after the ablation procedure was associated with significantly lower risk of acute pericarditis and related hospitalization. In addition, paroxysmal AF patients receiving colchicine had a higher arrhythmia-free survival rate compared with those not receiving colchicine.

• Authors: Sanghamitra Mohanty, Prasant Mohanty, Danielle Kessler, Carola Gianni, Karim K Baho, Trevor Morris, Tuna Yildiz, Angel Quintero Mayedo, Bryan MacDonald, Domenico G Della Rocca, Amin Al-Ahmad, Mohamed Bassiouny, G Joseph Gallinghouse, Rodney Horton, John D Burkhardt, Luigi di Biase, Andrea Natale
• Journal: JACC. Clinical electrophysiology (JACC Clin Electrophysiol) Vol. 9 Issue 7 Pt 2 Pg. 1051-1059 (07 2023) ISSN: 2405-5018 [Electronic] United States
• PMID: 37086226 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Chemical References

• Colchicine

Topics

• Humans
• Atrial Fibrillation (drug therapy, surgery, diagnosis)
• Treatment Outcome
• Colchicine (therapeutic use)
• Catheter Ablation (adverse effects, methods)
• Pericarditis (epidemiology, etiology, surgery)