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The effect of short-term steroid therapy for preventing atrial tachyarrhythmias in blanking period after catheter ablation of atrial fibrillation |
울산대학교 의과대학 서울아산병원 순환기내과 |
김유리, 김성환,남기병,최형오,김용균,황기원,최기준,김유호 |
Background
Atrial arrhythmias occurring during the first 3-12 weeks (blanking period) after Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) can be highly symptomatic and often require an anti-arrhythmic drug (AAD), cardioversion or hospitalization.
Objectives
The anti-inflammatory effect of corticosteroid may suppress these atrial arrhythmias during blanking period after catheter ablation of atrial fibrillation.
Methods
We prospectively enrolled 83 patients who were randomly assigned to 2 groups (steroid and control group). The primary end points were atrial tachyarrhythmias or severe symptomatic PAC on regularly follow-up Holter monitoring at 12 lead ECG if patient had symptoms in post RFCA 6 months and clinical events (hospitalization and cardioversion) in 2 months after the ablation.
Result
During follow-up (median, 182 days), a total of 14 patients were hospitalized due to recurrent atrial tachyarrhythmias and cardioversion. There was no significant different in hospitalization and cardioversion between the two groups (18.4% vs 15.3% at 2 months; P=0.78).
But the incidence of AAD administration to control symptomatic atrial arrhythmia was significantly lower in steroid group then in the control group (21.1% vs. 60.0% at 2 months; P<0.0001).
After adjusting clinical and procedural characteristics, short-term steroid administration was independently associated with lower rate of atrial arrhythmias on Holter monitoring (adjusted HR 0.31, 95% CI 0.11-0.86, p=0.024).
Conclusion
Our data suggest that use of peri-procedural short-term corticosteroid significantly reduced the incidence of atrial tachyarrhythmias and the use of AAD during blanking period after catheter ablation of AF.
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