Introduction
Atrial fibrillation (AF) is the most common sustained arrhythmia,
diagnosed in 2-3% of patients worldwide1. AF
contributes to an extensive degree of morbidity and mortality that is
responsible for significant utilization of healthcare
resources1. Radiofrequency ablation has been
established as a safe and effective therapy for AF. In recent years,
trials such as EAST-AFNET 4 have established the benefit of early rhythm
control for decreasing cardiovascular death, stroke, and
hospitalizations2. As a result, catheter ablation (CA)
has moved to the forefront of AF treatment as an effective means of
maintaining rhythm control and reducing AF recurrence.
The lesions applied during CA produce localized necrosis and resulting
electrical isolation but can also trigger an inflammatory response that
has been postulated to play a role in recurrence of
AF4. Colchicine is an oral medication that acts
primarily by inhibiting microtubule polymerization in neutrophils,
disrupting their migration to inflammatory foci5.
Colchicine also suppresses the activation of the NLRP3 (NACHT, LRR, and
PYD domain containing protein 3) inflammasome, reducing the expression
of various interleukins5. Consequently, the use of
colchicine has been explored extensively as an anti-inflammatory
therapeutic and has proven effective for the treatment of acute,
recurrent, and post-pericardiotomy pericarditis in the COPE, CORE, and
COPPS trials6.
Several smaller studies have investigated the efficacy of standard dose
colchicine for the prevention of post-ablation AF recurrence, with
conflicting results and high rates of medication side
effects13. There are no formal society recommendations
regarding the use of colchicine after CA for AF14-16.
In this study, we report our single center experience with low dose
colchicine for the prevention of long-term AF recurrence after AF
ablation.