Colchicine for prevention of atrial fibrillation recurrence after pulmonary vein isolation: Mid-term efficacy and effect on quality of life

Deftereos, Spyridon; Γιαννόπουλος, Γεώργιος; Efremidis, Michael; Kossyvakis, Charalampos; Katsivas, Apostolos; Panagopoulou, Vasiliki; Papadimitriou, Charalampos; Karageorgiou, Sofia; Doudoumis, Konstantinos; Raisakis, Konstantinos; Kaoukis, Andreas; Alexopoulos, Dimitrios; Manolis, Antonis S.; Stefanadis, Christodoulos; Cleman, Michael

doi:10.1016/j.hrthm.2014.02.002

Cited by 119 publications

(86 citation statements)

References 23 publications

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“…Colchicine, an anti-inflammatory agent, was shown in 1 RCT to reduce the risk of recurrence of AF in the first 12 months after ablation. 85 Patients given colchicine in the first 3 months after ablation had a reduced risk of AF in months 3 through 12 (31.2% versus 49.5%; P=0.010). Another study evaluated the periprocedural use of steroids to decrease the risk of AF in the first 3 months after ablation.…”

Section: State Of the Artmentioning

confidence: 93%

Ablation of Atrial Fibrillation

2016

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Atrial fibrillation (AF) is the most common arrhythmia encountered by cardiologists and is a major cause of morbidity and mortality. Risk factors for AF include age, male sex, genetic predisposition, hypertension, diabetes mellitus, sleep apnea, obesity, excessive alcohol, smoking, hyperthyroidism, pulmonary disease, air pollution, heart failure, and possibly excessive exercise. The management of AF involves decisions about rate versus rhythm control. Asymptomatic patients are generally managed with rate control and anticoagulation. Symptomatic patients will desire rhythm control. Rhythm control options are either antiarrhythmic agents or ablation, with each having its own risks and benefits. Ablation of AF has evolved from a rare and complex procedure to a common electrophysiological technique. Selection of patients to undergo ablation is an important aspect of AF care. Patients with the highest success rates of ablation are those with normal structural hearts and paroxysmal AF, although those with congestive heart failure have the greatest potential benefit of the procedure. Although pulmonary vein isolation of any means/energy source is the approach generally agreed on for those with paroxysmal AF, optimal techniques for the ablation of nonparoxysmal AF are not yet clear. Anticoagulation reduces thromboembolic complications; the newer anticoagulants have eased management for both the patient and the cardiologist. Aggressive management of modifiable risk factors (hypertension, diabetes mellitus, sleep apnea, obesity, excessive alcohol, smoking, hyperthyroidism, pulmonary disease, air pollution, and possibly excessive exercise) after ablation reduces the odds of recurrent AF and is an important element of care.

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Section: State Of the Artmentioning

confidence: 93%

Ablation of Atrial Fibrillation

2016

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“…Between some new treatment approaches [43,44], there is already some evidence for possible beneficial roles of anti-inflammatory therapies for prevention of the development of AF [45] as well. Colchicine was shown to be able to reduce the rate of recurrences of AF after pulmonary vein isolation [46], whereas corticosteroids significantly reduce the risk of postoperative AF [7,47,48]. In conclusion, inflammatory targets for modulation of thrombotic processes seem to be worthwhile approaches for further studies.…”

Section: Predictors Of Thrombogenicity In Patients With Afmentioning

confidence: 94%

Monocyte–platelet aggregates and CD11b expression as markers for thrombogenicity in atrial fibrillation

et al. 2015

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“…66 Two hundred twenty-three randomized patients underwent ablation and 206 patients were available for analysis. AF recurrence rate in the colchicine group was 31.1% (32/103) versus 49.5% (51/103) in the control group (P=0.010).…”

Section: Maintenance Post Ablation Colchicinementioning

confidence: 99%