PO-02-170 EFFECT OF LOW DOSE COLCHICINE USE ON RECURRENCE OF ATRIAL FIBRILLATION AFTER CATHETER ABLATION

Abstract

Colchicine is commonly used early after atrial fibrillation (AF) ablation to reduce AF recurrence, but there is limited efficacy data. To evaluate the effect of colchicine use on AF recurrence after ablation. From 2013 to 2021, all AF ablations performed at a single tertiary care medical center were analyzed for colchicine use, clinical and procedural characteristics, and AF recurrence. The colchicine dose was 0.3-0.6mg once daily. The primary outcome was AF recurrence, defined as AF detection for more than 30 seconds after a 3 month blanking period. Propensity score matching (PSM, 1:1 match) was performed using the covariates of gender, age, BMI, AF classification, hypertension (HTN), and diabetes mellitus (DM) based on significant predictors of AF recurrence in prior studies. The minimum duration of follow-up was 6 months. Kaplan-Meier analysis was conducted to assess time to AF recurrence in the entire cohort and the PSM cohort. The study population consisted of 1544 AF ablations in 1231 patients (67% male, age 65 ± 7 years and mean follow up 34 ± 14 months); 78% of the patients received colchicine. Baseline characteristics in colchicine vs no colchicine group showed males (65 vs 69%), mean age (67 vs 63 years), BMI (30 vs 31), paroxysmal AF (70 vs 82%), DM (16 vs 17%), HTN (60 vs 54%), and obstructive sleep apnea (OSA) (18 vs 19%). Colchicine use was associated with decreased AF recurrence (HR 0.78, CI 0.63-0.96, p=0.022; Figure 1A). After PSM, there were 275 patients in each group. Baseline characteristics were not significantly different between both groups. AF recurrence was lower with colchicine (HR 0.71, CI 0.53-0.96, p=0.026; Figure 1B). Colchicine use was associated with decreased AF recurrence in patients with paroxysmal AF (HR 0.70, CI 0.50-0.98, p=0.036) but not persistent AF (HR 0.79, CI 0.39-1.59, p=0.5). Colchicine use was associated with decreased AF recurrence in patients undergoing repeat AF ablation (HR 0.55, CI 0.32-0.96, p=0.036) but not de novo ablation (HR 0.77, CI 0.54-1.1, p=0.2). Colchicine use was associated with lower AF recurrence in patients undergoing AF ablation.