Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece; Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut.
Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece; Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut.
Heart Rhythm. 2014 Apr;11(4):620-8. doi: 10.1016/j.hrthm.2014.02.002. Epub 2014 Feb 4.
Our group previously showed that colchicine treatment is associated with decreased early recurrence rate after ablation for atrial fibrillation (AF).
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.
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.
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).
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.
我们的团队之前曾表明，秋水仙碱治疗与房颤（AF）消融后早期复发率降低有关。
本研究旨在测试秋水仙碱在阵发性 AF 患者单次肺静脉隔离后减少 AF 复发的中期疗效。评估生活质量（QOL）变化是次要目标。
计划进行消融的阵发性 AF 患者被随机分为秋水仙碱 0.5mg 每日两次的 3 个月疗程或安慰剂组，并随访中位数为 15 个月（有 3 个月的空白期）。使用一般健康相关 QOL 工具（26 项世界卫生组织 QOL 问卷）在基线、3 个月和 12 个月时评估 QOL。
223 名随机患者接受了消融，206 名患者可进行分析（144 名男性，年龄 62.2±5.8 岁）。秋水仙碱组的 AF 复发率为 31.1%（32/103），对照组为 49.5%（51/103）（P=0.010），相对风险降低 37%（比值比 0.46，95%置信区间 0.26-0.81）。治疗人数为 6（95%置信区间 3.2-19.8）。秋水仙碱组 12 个月时的身体领域 QOL 评分分别为 63.6±13.8，对照组为 52.5±18.1，而心理领域评分分别为 56.1±13.7 vs 44.7±17.3（均 P<0.001）。
阵发性 AF 肺静脉隔离后秋水仙碱治疗与单次手术后 AF 复发率降低相关。这种减少伴随着身体和心理健康相关 QOL 评分的相应改善。
