title: Colchicine for prevention of early atrial fibrillation recurrence after pulmonary vein isolation: a randomized controlled study.
abstract: OBJECTIVE
  The purpose of the present study was to test the potential of colchicine, an agent with potent anti-inflammatory action, to reduce atrial fibrillation (AF) recurrence after pulmonary vein isolation in patients with paroxysmal AF.
  
  
  BACKGROUND
  Proinflammatory processes induced by AF ablation therapy have been implicated in postablation arrhythmia recurrence.
  
  
  METHODS
  Patients with paroxysmal AF who received radiofrequency ablation treatment were randomized to a 3-month course of colchicine 0.5 mg twice daily or placebo. C-reactive protein (CRP) and interleukin (IL)-6 levels were measured on day 1 and on day 4 of treatment.
  
  
  RESULTS
  In the 3-month follow-up, recurrence of AF was observed in 27 (33.5%) of 80 patients of the placebo group versus 13 (16%) of 81 patients who received colchicine (odds ratio: 0.38, 95% confidence interval: 0.18 to 0.80). Gastrointestinal side-effects were the most common symptom among patients receiving active treatment. Diarrhea was reported in 7 patients in the colchicine group (8.6%) versus 1 in the placebo group (1.3%, p = 0.03). Colchicine led to higher reductions in CRP and IL-6 levels: the median difference of CRP and IL-6 levels between days 4 and 1 was -0.46 mg/l (interquartile range: -0.78 to 0.08 mg/l) and -0.10 mg/l (-0.30 to 0.10 pg/ml), respectively, in the placebo group versus -1.18 mg/l (-2.35 to -0.46 mg/l) and -0.50 pg/ml (-1.15 to -0.10 pg/ml) in the colchicine group (p < 0.01 for both comparisons).
  
  
  CONCLUSIONS
  Colchicine is an effective and safe treatment for prevention of early AF recurrences after pulmonary vein isolation in the absence of antiarrhythmic drug treatment. This effect seems to be associated strongly with a significant decrease in inflammatory mediators, including IL-6 and CRP.
authors.affiliation: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Deftereos
authors.forename: Georgios
authors.initials: G
authors.lastname: Giannopoulos
authors.forename: Charalambos
authors.initials: C
authors.lastname: Kossyvakis
authors.forename: Michael
authors.initials: M
authors.lastname: Efremidis
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Panagopoulou
authors.forename: Andreas
authors.initials: A
authors.lastname: Kaoukis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Raisakis
authors.forename: Georgios
authors.initials: G
authors.lastname: Bouras
authors.forename: Christos
authors.initials: C
authors.lastname: Angelidis
authors.forename: Andreas
authors.initials: A
authors.lastname: Theodorakis
authors.forename: Metaxia
authors.initials: M
authors.lastname: Driva
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Doudoumis
authors.forename: Vlasios
authors.initials: V
authors.lastname: Pyrgakis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac; D001281:Atrial Fibrillation / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000096:biosynthesis; D003078:Colchicine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010919:Placebos; D011667:Pulmonary Veins / Q000473:pathology*; D012008:Recurrence; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000627:therapeutic use
chemical_list: D015850:Interleukin-6; D010919:Placebos; D050257:Tubulin Modulators; D002097:C-Reactive Protein; D003078:Colchicine