Sardu Celestino, Santulli Gaetano, Santamaria Matteo, Barbieri Michelangela, Sacra Cosimo, Paolisso Pasquale, D'Amico Fabio, Testa Nicola, Caporaso Igor, Paolisso Giuseppe, Marfella Raffaele, Rizzo Maria Rosaria
Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy; Arrhythmias and Electrophysiology Department, John Paul II Research Foundation, Campobasso, Italy.
Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy; New York Presbyterian Hospital, Columbia University Medical Center, New York, New York.
Am J Cardiol. 2017 May 1;119(9):1382-1386. doi: 10.1016/j.amjcard.2017.01.040. Epub 2017 Feb 10.
Catheter ablation (CA) is a procedure commonly used to restore sinus rhythm in patients with atrial fibrillation (AF). However, AF recurrence after CA remains a relevant clinical issue. We tested the effects of an oral antioxidant treatment (alpha lipoic acid [ALA]) on AF recurrence post-CA. Patients with paroxysmal AF have been enrolled in a randomized, prospective, double-blind, controlled placebo trial. After CA, patients have been randomly assigned to receive ALA oral supplementation (ALA group) or placebo (control group) and evaluated at baseline and after a 12-month follow-up: 73 patients completed the 12-month follow-up (ALA: 33 and control: 40). No significant difference has been detected between the 2 groups at baseline. Strikingly, 1 year after CA, ALA therapy significantly reduced serum markers of inflammation. However, there was no significant difference in AF recurrence events at follow-up comparing ALA with placebo group. Multivariate analysis revealed that the only independent prognostic risk factor for AF recurrence after CA is age. In conclusion, ALA therapy reduces serum levels of common markers of inflammation in ablated patients. Nevertheless, ALA does not prevent AF recurrence after an ablative treatment.
导管消融术(CA)是一种常用于恢复房颤(AF)患者窦性心律的手术。然而,CA术后房颤复发仍然是一个相关的临床问题。我们测试了口服抗氧化剂治疗(α硫辛酸[ALA])对CA术后房颤复发的影响。阵发性房颤患者已被纳入一项随机、前瞻性、双盲、对照安慰剂试验。CA术后,患者被随机分配接受ALA口服补充剂(ALA组)或安慰剂(对照组),并在基线和12个月随访后进行评估:73例患者完成了12个月的随访(ALA组:33例,对照组:40例)。两组在基线时未检测到显著差异。令人惊讶的是,CA术后1年,ALA治疗显著降低了炎症血清标志物。然而,随访时ALA组与安慰剂组的房颤复发事件无显著差异。多变量分析显示,CA术后房颤复发的唯一独立预后危险因素是年龄。总之,ALA治疗可降低消融患者炎症常见标志物的血清水平。然而,ALA并不能预防消融治疗后房颤的复发。