title: Effect of Short-Term Steroid Therapy on Early Recurrence During the Blanking Period After Catheter Ablation of Atrial Fibrillation.
abstract: BACKGROUND
  Early recurrence (ER) of atrial tachyarrhythmias during the first 3 months (blanking period) after atrial fibrillation ablation can be highly symptomatic, often requiring emergency treatment. Short-term steroid therapy may suppress ER during the blanking period.
  
  
  RESULTS
  We prospectively enrolled 138 patients who were randomly assigned to 2 groups (steroid group and control group). An intravenous bolus of 0.5 mg/kg of methylprednisolone for 2 days followed by 12 mg daily of oral methylprednisolone for 4 days was given to the steroid group patients. The primary end point was ER during the blanking period (3 months post ablation). During the blanking period, 51 of the 138 (37.0%) patients experienced ER after atrial fibrillation ablation. The steroid group had a lower rate of ER than the control group (15/64 [23.4%] versus 36/74 [48.6%], P=0.003). There was no difference between the 2 groups about late recurrence during a 24-month follow-up (log-rank test, P=0.918). In a multivariate analysis, short-term steroid therapy was independently associated with a lower rate of ER during the blanking period (adjusted OR, 0.45; 95% confidence interval, 0.25-0.83; P=0.01).
  
  
  CONCLUSIONS
  Periprocedural short-term moderate intensity steroid therapy reduces ER (≈3 months) after catheter ablation of atrial fibrillation. It is not effective in preventing late (3≈24 m) atrial fibrillation recurrence.
  
  
  BACKGROUND
  URL: www.who.int/ictrp; Unique identifier: KCT0000107.
authors.affiliation: From the Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital (Y.R.K.) and Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital (S.-H.K.), College of Medicine, The Catholic University of Korea, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (G.-B.N., J.K., Y.-H.K.); Department of Applied Statistics, Gachon University, Seongnam, South Korea (S.H.); and Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea (K.-H.K.).
authors.forename: Yoo Ri
authors.initials: YR
authors.lastname: Kim
authors.affiliation: From the Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital (Y.R.K.) and Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital (S.-H.K.), College of Medicine, The Catholic University of Korea, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (G.-B.N., J.K., Y.-H.K.); Department of Applied Statistics, Gachon University, Seongnam, South Korea (S.H.); and Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea (K.-H.K.). gbnam@amc.seoul.kr.
authors.forename: Gi-Byoung
authors.initials: GB
authors.lastname: Nam
authors.affiliation: From the Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital (Y.R.K.) and Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital (S.-H.K.), College of Medicine, The Catholic University of Korea, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (G.-B.N., J.K., Y.-H.K.); Department of Applied Statistics, Gachon University, Seongnam, South Korea (S.H.); and Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea (K.-H.K.).
authors.forename: Seungbong
authors.initials: S
authors.lastname: Han
authors.affiliation: From the Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital (Y.R.K.) and Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital (S.-H.K.), College of Medicine, The Catholic University of Korea, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (G.-B.N., J.K., Y.-H.K.); Department of Applied Statistics, Gachon University, Seongnam, South Korea (S.H.); and Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea (K.-H.K.).
authors.forename: Sung-Hwan
authors.initials: SH
authors.lastname: Kim
authors.affiliation: From the Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital (Y.R.K.) and Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital (S.-H.K.), College of Medicine, The Catholic University of Korea, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (G.-B.N., J.K., Y.-H.K.); Department of Applied Statistics, Gachon University, Seongnam, South Korea (S.H.); and Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea (K.-H.K.).
authors.forename: Ki-Hun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: From the Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital (Y.R.K.) and Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital (S.-H.K.), College of Medicine, The Catholic University of Korea, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (G.-B.N., J.K., Y.-H.K.); Department of Applied Statistics, Gachon University, Seongnam, South Korea (S.H.); and Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea (K.-H.K.).
authors.forename: Sulhee
authors.initials: S
authors.lastname: Lee
authors.affiliation: From the Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital (Y.R.K.) and Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital (S.-H.K.), College of Medicine, The Catholic University of Korea, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (G.-B.N., J.K., Y.-H.K.); Department of Applied Statistics, Gachon University, Seongnam, South Korea (S.H.); and Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea (K.-H.K.).
authors.forename: Jun
authors.initials: J
authors.lastname: Kim
authors.affiliation: From the Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital (Y.R.K.) and Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital (S.-H.K.), College of Medicine, The Catholic University of Korea, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (G.-B.N., J.K., Y.-H.K.); Department of Applied Statistics, Gachon University, Seongnam, South Korea (S.H.); and Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea (K.-H.K.).
authors.forename: Kee-Joon
authors.initials: KJ
authors.lastname: Choi
authors.affiliation: From the Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital (Y.R.K.) and Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital (S.-H.K.), College of Medicine, The Catholic University of Korea, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (G.-B.N., J.K., Y.-H.K.); Department of Applied Statistics, Gachon University, Seongnam, South Korea (S.H.); and Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea (K.-H.K.).
authors.forename: You-Ho
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000284:Administration, Oral; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007275:Injections, Intravenous; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D056910:Republic of Korea; D012307:Risk Factors; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: atrial fibrillation; catheter ablation; glucocorticoids; methylprednisolone; multivariate analysis