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.