title: Impact of Periprocedural Colchicine on Postprocedural Management in Patients Undergoing a Left Atrial Appendage Ligation Using LARIAT.
abstract: BACKGROUND
  Left atrial appendage (LAA) can be effectively and safely excluded using a novel percutaneous LARIAT ligation system. However, due to pericardial catheter manipulation and LAA ligation and subsequent necrosis, postprocedural course is complicated by pericarditis. We intended to evaluate the preprocedural use of colchicine on the incidence of postprocedural pericardial complications.
  
  
  RESULTS
  In this multicenter observational study, we included all consecutive patients who underwent LARIAT procedure at the participating centers. Many patients received periprocedural colchicine at the discretion of the physician. We compared the postprocedural outcomes of patients who received prophylactic periprocedural colchicine (colchicine group) with those who did not receive colchicine (standard group). A total of 344 consecutive patients, 243 in the "colchicine group" and 101 in the "standard group," were included. The mean age, median CHADS2VASc score, and HASBLED scores were 70 ± 11 years, 3 ± 1.7, and 3 ± 1.1, respectively. There were no significant differences in major baseline characteristics between the two groups. Severe pericarditis was significantly lower in the "colchicine group" compared to the "standard group" (10 [4%] vs. 16 [16%] P<0.0001). The colchicine group, compared to the standard group, had lesser pericardial drain output (186 ± 84 mL vs. 351 ± 83, P<0.001), shorter pericardial drain duration (16 ± 4 vs. 23 ± 19 hours, P<0.04), and similar incidence of delayed pericardial effusion (4 [1.6%] to 3 [3%], P = 0.42) when compared to the standard group.
  
  
  CONCLUSIONS
  Use of colchicine periprocedurally was associated with significant reduction in postprocedural pericarditis and associated complications.
authors.affiliation: University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Sampath
authors.initials: S
authors.lastname: Gunda
authors.affiliation: University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Madhu
authors.initials: M
authors.lastname: Reddy
authors.affiliation: University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Jayant
authors.initials: J
authors.lastname: Nath
authors.affiliation: Nebraska Heart Institute, Lincoln, Nebraska, USA.
authors.forename: Hosakote
authors.initials: H
authors.lastname: Nagaraj
authors.affiliation: University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Moustapha
authors.initials: M
authors.lastname: Atoui
authors.affiliation: Texas Heart Institute, Houston, Texas, USA.
authors.forename: Abdi
authors.initials: A
authors.lastname: Rasekh
authors.affiliation: Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Ellis
authors.affiliation: University of California, San Francisco, California, USA.
authors.forename: Nitish
authors.initials: N
authors.lastname: Badhwar
authors.affiliation: University of California, San Francisco, California, USA.
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Lee
authors.affiliation: Texas Cardiac Arrhythmia Institute at St. David's Medical Center and Albert Einstein College of Medicine at Montefiore Hospital, Austin, Texas, USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: DI Biase
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Moussa
authors.initials: M
authors.lastname: Mansour
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Jeremy N
authors.initials: JN
authors.lastname: Ruskin
authors.affiliation: Texas Cardiac Arrhythmia Institute, Austin, Texas, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.affiliation: University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Earnest
authors.affiliation: University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Dhanunjaya R
authors.initials: DR
authors.lastname: Lakkireddy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D003078:Colchicine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D000893:Anti-Inflammatory Agents; D003078:Colchicine
keywords: LARIAT procedure; atrial fibrillation; colchicine; left atrial appendage; pericarditis; stroke