The efficacy of colchicine in preventing atrial fibrillation recurrence and pericarditis post-catheter ablation for atrial fibrillation – A systematic review and meta-analysis of prospective studies

Authors

Vamsikalayan Borra, The University of Texas Rio Grande ValleyFollow
Arankesh Mahadevan
Sidhartha Gautam Senapati
Roopeessh Vempati
Vikash Jaiswal
Nithya Borra
Javaria Ahmad
Oscar Rodrigo Zamudio Herrera
Carlos Vergara Sanchez
Tanisha Prasad

Document Type

Article

Publication Date

8-2024

Abstract

Highlights

• Recurrent AF after CA occurred in 29.0% of the colchicine group and 39.5% of the placebo group.

• Post-ablation pericarditis occurred in 5.3 % of the colchicine group and 16.5% of the placebo group.

• Pooled analysis of prospective studies showed that colchicine decreased the odds of recurrent AF [OR: 0.63 (95 % CI: 0.50–0.78), p < 0.01, I2 = 8 %] and post-ablation pericarditis [OR: 0.34 (95 % CI: 0.16–0.75), p < 0.01, I2 = 57 %].

Introduction

Catheter ablation (CA) initiates a proinflammatory process responsible for atrial fibrillation (AF) recurrence (25–40%) and pericarditis (0.8%). Due to its anti-inflammatory properties, colchicine, a microtubule inhibitor, is explored for the prevention of early AF recurrence and pericarditis after pulmonary vein isolation. We performed a pooled analysis to determine the rates of AF recurrence and pericarditis after CA in patients receiving colchicine.

Methods

A comprehensive literature review was conducted on PubMed and SCOPUS from inception to December 2023 using medical subject headings and keywords, followed by a citation and reference search. We identified prospective studies reporting recurrent AF and pericarditis outcomes after catheter ablation in patients taking colchicine versus placebo. A binary random effects model was used to estimate pooled odds ratios and 95% confidence intervals. Sensitivity analysis was conducted using the leave-one-out method, and heterogeneity was assessed using the I2 statistic.

Results

Of the 958 identified studies, 4 met our inclusion criteria. A total of 1,619 patients were analyzed; 743 received colchicine, and 875 were in the placebo group. Recurrent AF after CA occurred in 192 (29.0 %) of the colchicine group and 318 (39.5 %) of the placebo group. Post-ablation pericarditis occurred in 34 (5.3 %) of the colchicine group and 128 (16.5 %) of the placebo group. Pooled analysis of prospective studies showed that colchicine decreased the odds of recurrent AF [OR: 0.63 (95 % CI: 0.50–0.78), p < 0.01, I2 = 8 %] and post-ablation pericarditis [OR: 0.34 (95 % CI: 0.16–0.75), p < 0.01, I2 = 57 %]. Odds of GI disturbance were increased with colchicine use in our analysis [OR: 2.77 (95 % CI: 1.17–6.56), p = 0.02, I2 = 84 %].

Conclusion

Colchicine use is associated with decreased odds of recurrent AF and pericarditis post-CA from the analysis of prospective studies. These results underscore the potential for colchicine therapy for future exploration with randomized and controlled research with different dosages.

Comments

http://creativecommons.org/licenses/by/4.0/

Recommended Citation

Borra, V., Mahadevan, A., Gautam Senapati, S., Vempati, R., Jaiswal, V., Borra, N., Ahmad, J., Rodrigo Zamudio Herrera, O., Vergara Sanchez, C., Prasad, T., Thachil, R., Ganatra, S., & Dani, S. (2024). The efficacy of colchicine in preventing atrial fibrillation recurrence and pericarditis post-catheter ablation for atrial fibrillation – A systematic review and meta-analysis of prospective studies. IJC Heart & Vasculature, 53, 101466. https://doi.org/10.1016/j.ijcha.2024.101466

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication Title

IJC Heart & Vasculature

DOI

https://doi.org/10.1016/j.ijcha.2024.101466

Academic Level

resident

Mentor/PI Department

Internal Medicine