Po-03-071 short-term colchicine after catheter ablation for atrial fibrillation – a randomized, placebo-controlled trial

Inflammation may promote arrhythmia recurrence following catheter ablation for atrial fibrillation (AF). To study the effects of a short-term anti-inflammatory treatment with colchicine following ablation. Patients scheduled for catheter ablation for AF were randomly assigned to receive colchicine 0.6 mg twice daily or placebo for 10 days. The first dose of study drug was administered before ablation. Arrhythmia recurrence was defined as AF, atrial flutter or atrial tachycardia >30 seconds on two 14-day Holters, done immediately after and at 3 months following ablation. The analysis included 199 patients (median age 61 years, 22% female, 30% with prior catheter ablation; radiofrequency ablation 79%, cryoablation 21%). Antiarrhythmic drugs were prescribed at hospital discharge in 149 patients (75%). Colchicine did not reduce Holter-detected arrhythmia recurrence at 2 weeks (31% vs. 32%, hazard ratio [HR] 0.98, 95% confidence interval [CI] 0.59-1.61, p=0.92) or at 3 months following ablation (14% vs. 15%, HR 0.95, 95% CI 0.45-2.02, p=0.89). Colchicine reduced post-ablation chest pain consistent with pericarditis (4% vs. 15%, HR 0.26, 95% CI 0.09-0.77, p=0.02) and increased diarrhea (26% vs. 7%, HR 4.74, 95% CI 1.95-11.53, p<0.001). During a median follow-up of 1.3 years, colchicine did not reduce healthcare utilization (any of emergency department visit, cardiovascular hospitalization, cardioversion or repeat ablation) (29 vs. 25 per 100 patient-years, HR 1.18, 95% CI 0.69-1.99, p=0.55). Colchicine administered for 10 days following catheter ablation for AF did not reduce arrhythmia recurrence or healthcare utilization. Colchicine did reduce post-ablation chest pain and increase diarrhea.