Colchicine for prevention of atrial fibrillation recurrence after pulmonary veinisolation: Mid-term efficacy and effect on quality of life
BACKGROUND Our group previously showed that colchicine treat- ment is associated with decreased early recurrence rate after ablation for atrial ﬁbrillation (AF).
OBJECTIVE The purpose of this study was to test the mid-term efﬁcacy of colchicine in reducing AF recurrences after a single procedure of pulmonary vein isolation in patients with paroxysmal AF. Assessment of quality-of-life (QOL) changes was a secondary objective.
METHODS Patients with paroxysmal AF who were scheduled for ablation were randomized to a 3-month course of colchicine 0.5 mg twice daily or placebo and were followed for a median of 15 months (with a 3-month blanking period). QOL was assessed with a general- purpose health-related QOL tool (26-item World Health Organiza- tion QOL questionnaire) at baseline and after 3 and 12 months.
RESULTS Two hundred twenty-three randomized patients under- went ablation, and 206 patients were available for analysis (144 male, age 62.2 ± 5.8 years). AF recurrence rate in the colchicine group was 31.1% (32/103) vs 49.5% (51/103) in the control group (P ¼ .010), translated in a relative risk reduction of 37% (odds ratio 0.46, 95% conﬁdence interval 0.26–0.81). The number needed to treat was 6 (95% conﬁdence interval 3.2–19.8). Physical domain QOL scores at 12 months were 63.6 ± 13.8 in the colchicine group and 52.5 ± 18.1 in controls, whereas psychological domain scores were 56.1 ± 13.7 vs 44.7 ± 17.3, respectively (P o.001, for both).
CONCLUSION Colchicine treatment after pulmonary vein isolation for paroxysmal AF is associated with lower AF recurrence rates after a single procedure. This reduction is accompanied by corresponding improvements in physical and psychological health-related QOL scores.
KEYWORDS Atrial ﬁbrillation; Colchicine; Inﬂammation; Antiinﬂammatory; Interleukin-6; C-reactive protein
ABBREVIATIONS AF ¼ atrial ﬁbrillation; CRP ¼ C-reactive protein; IL-6 ¼ interleukin-6; QOL ¼ quality of life
(Heart Rhythm 2014;11:620–628) I 2014 Heart Rhythm Society. All rights reserved.