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.