title: 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).
  
  
  CONCLUSIONS
  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: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece; Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors: Spyridon
authors: S
authors: Deftereos
authors: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece; Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut. Electronic address: ggiann@med.uoa.gr.
authors: Georgios
authors: G
authors: Giannopoulos
authors: 2nd Department of Cardiology, Evaggelismos General Hospital, Athens, Greece.
authors: Michael
authors: M
authors: Efremidis
authors: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece.
authors: Charalampos
authors: C
authors: Kossyvakis
authors: 1st Department of Cardiology, Red Cross Hospital, Athens, Greece.
authors: Apostolos
authors: A
authors: Katsivas
authors: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece.
authors: Vasiliki
authors: V
authors: Panagopoulou
authors: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece.
authors: Charalampos
authors: C
authors: Papadimitriou
authors: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece.
authors: Sofia
authors: S
authors: Karageorgiou
authors: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece.
authors: Konstantinos
authors: K
authors: Doudoumis
authors: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece.
authors: Konstantinos
authors: K
authors: Raisakis
authors: Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece.
authors: Andreas
authors: A
authors: Kaoukis
authors: Department of Cardiology, University of Patras, Patras, Greece.
authors: Dimitrios
authors: D
authors: Alexopoulos
authors: 1st Department of Cardiology, University of Athens Medical School, Athens, Greece.
authors: Antonis S
authors: AS
authors: Manolis
authors: 1st Department of Cardiology, University of Athens Medical School, Athens, Greece.
authors: Christodoulos
authors: C
authors: Stefanadis
authors: Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors: Michael W
authors: MW
authors: Cleman
mesh_terms: D001281:Atrial Fibrillation / Q000517:prevention & control* / Q000601:surgery; D003078:Colchicine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care; D011667:Pulmonary Veins / Q000601:surgery*; D011788:Quality of Life; D012008:Recurrence; D040242:Risk Reduction Behavior
chemical_list: D003078:Colchicine
keywords: Antiinflammatory; Atrial fibrillation; C-reactive protein; Colchicine; Inflammation; Interleukin-6