Effect of Low Dose Colchicine on Long term Recurrence After Atrial
Fibrillation Ablation
Abstract
Background: Colchicine is commonly used early after atrial
fibrillation (AF) ablation to reduce inflammation and reduce AF
recurrence, but there is limited long-term efficacy data.
Objective: To evaluate the effect of low dose colchicine use on
long-term AF recurrence after AF ablation. Methods: From 2013
to 2021, all AF ablations performed at a single tertiary care medical
center were analyzed for colchicine use, clinical and procedural
characteristics, and AF recurrence. The colchicine dose was 0.3-0.6 mg
once daily for 30 days. The primary outcome was AF recurrence, defined
as AF detection for more than 30 seconds after a three-month blanking
period. Propensity score matching (PSM, 1:1 match) was performed using
covariates that were significant predictors of AF recurrence in prior
studies. The minimum duration of follow-up was 6 months. Kaplan-Meier
analysis was conducted to assess time to AF recurrence in the entire
cohort and the PSM cohort. Results: The study population
consisted of 1568 AF ablations in 1412 patients (67% male, age 65 ± 7
years and mean follow up 34 ± 14 months); 78% of the patients received
colchicine. Colchicine use was associated with decreased AF recurrence
(HR 0.78, CI 0.63-0.96, p=0.022). After PSM there were 275 patients in
each group. AF recurrence was lower with colchicine (HR 0.71, CI
0.53-0.96, p=0.026). Conclusions: Low dose colchicine use was
associated with lower long-term AF recurrence after AF ablation. A
randomized, placebo-controlled trial is warranted to confirm if low dose
colchicine should be used routinely after AF ablation.