Effect of low dose colchicine on long term recurrence after atrial fibrillation ablation

Background: Colchicine is commonly used early after atrial fibrillation (AF) ablation to reduce inflammation and reduce AF recurrence, but there is limited long-term efficacy data. Objective: To evaluate the effect of low dose colchicine use on long-term AF recurrence after AF ablation. Methods: 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 0.3–0.6 mg once daily for 30 days. The primary outcome was AF recurrence, defined as AF detection for more than 30 s after a three-month blanking period. Propensity score matching (PSM, 1:1 match) was performed using covariates that were 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. Results: The study population consisted of 1568 AF ablations in 1412 patients (67 % male, age 65 ± 7 years and mean follow up 34 ± 14 months); 78 % of the patients received colchicine. Colchicine use was associated with decreased AF recurrence (HR 0.78, CI 0.63–0.96, p = 0.022). After PSM there were 275 patients in each group. AF recurrence was lower with colchicine (HR 0.71, CI 0.53–0.96, p = 0.026). Conclusions: Low dose colchicine use was associated with lower long-term AF recurrence after AF ablation. A randomized, placebo-controlled trial is warranted to confirm if low dose colchicine should be used routinely after AF ablation.