Effect of a single bolus injection of low-dose hydrocortisone for prevention of atrial fibrillation recurrence after radiofrequency catheter ablation

摘要

Background: The transient use of corticosteroid shortly after atrial fibrillation (AF) ablation might prevent immediate and mid-term AF recurrence; however, the effective dosage for preventing AF recurrence has not been determined. In this study, we evaluated whether low-dose hydrocortisone is effective for the prevention of AF recurrence after radiofrequency catheter ablation (RFCA). Methods and Results: We enrolled 89 AF patients (70 males, 55.8??10.9 years) who underwent RF ablation and were treated with single bolus injection of 100 mg hydrocorticosteroid (corticosteroid group). For the control group, we enrolled 120 sex- and age-matched AF patients (94 males, 55.4??10.5 years). Pericarditis occurred in 3 (2.5%) and 1 (1.1%) patients in the control and corticosteroid groups, respectively. The number of patients with immediate AF recurrence (??2 days) was 17 (14.5%) and 11 (12.4%) in the control and steroid groups, respectively (P=0.687). Treatment with low-dose steroid did not decrease early (3-30 days) AF recurrence (13 [11.1%] vs. 11 [12.5%], P=0.829) or late (??31 days) AF recurrence after ablation (26 [22.2%] vs. 13 [14.6%], P=0.209). There was no difference in cumulative survival free of late AF recurrence between the corticosteroid and control groups (P=0.57 by log-rank test). White blood cell count, C-reactive protein concentration and maximum body temperature also were unchanged by low-dose steroid. Conclusions: Single bolus injection of low-dose hydrocortisone after AF ablation is not effective for preventing AF recurrence during the mid-term follow-up period.