Colchicine for prevention of atrial fibrillation recurrence after pulmonary vein isolation: mid-term efficacy and effect on quality of life.

Abstract

BACKGROUND:

Our group previously showed that colchicine treatment 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 Organization QOL questionnaire) at baseline and after 3 and 12 months.

RESULTS:

Two hundred twenty-three randomized patients underwent 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 = .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 <.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.

• Authors: Spyridon Deftereos, Georgios Giannopoulos, Michael Efremidis, Charalampos Kossyvakis, Apostolos Katsivas, Vasiliki Panagopoulou, Charalampos Papadimitriou, Sofia Karageorgiou, Konstantinos Doudoumis, Konstantinos Raisakis, Andreas Kaoukis, Dimitrios Alexopoulos, Antonis S Manolis, Christodoulos Stefanadis, Michael W Cleman
• Journal: Heart rhythm (Heart Rhythm) Vol. 11 Issue 4 Pg. 620-8 (Apr 2014) ISSN: 1556-3871 [Electronic] United States
• PMID: 24508207 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Chemical References

• Colchicine

Topics

• Atrial Fibrillation (prevention & control, surgery)
• Colchicine (administration & dosage, therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Postoperative Care
• Pulmonary Veins (surgery)
• Quality of Life
• Recurrence
• Risk Reduction Behavior