The Effect of Short-Term Steroid Therapy for Preventing Atrial Tachyarrhythmias in Blanking Period after Catheter-Ablation of Atrial Fibrillation

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概要

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• <B>Background:</B> Atrial arrhythmias occurring during the first 6–12 weeks (blanking period) after ablation of atrial fibrillation (AF) can be highly symptomatic and often require an anti-arrhythmic drug (AAD), cardioversion or hospitalization. <B>Objectives:</B> The anti-inflammatory effect of corticosteroid may suppress atrial arrhythmias during blanking period. <B>Methods:</B> We prospectively enrolled 83 patients were randomly assigned to 2 groups (steroidand control group). The primary end point was hospitalization (ER visit, re-admission) and cardioversion or AAD administration. Secondary end points were atrial tachyarrhythmias or severe symptomatic PAC on holter monitoring in 1 month of the ablation. <B>Result:</B> During follow-up (median, 28.2 days), A total of 15 patients were hospitalized due to recurrent atrial tachyarrhythmias and cardioversion. There was no significant different in hospitalization and cardioversion between the two groups (23.7% vs 13.3% at a months; P=0.26). But the incidence of AAD administration to control symptomatic atrial arrhythmia was significantly lower in steroid group then control (31.6% vs. 84.4% at a month; P<0.0001). After adjusting clinical and procedural characteristics, short-term steroid administration was independently associated with lower rate of atrial arrhythmia on holter monitoring (adjusted HR 0.08, 95% CI 0.02–0.37, p=0.001). <B>Conclusion:</B> Our data suggest that use of peri-procedural short-term corticosteroid significantly reduced the incidence of atrial tachyarrhythmias and AAD administration during blanking period after ablation of AF.

著者

• Kim You-ho

  Asan Medical Center Department Of Internal Medicine University Of Ulsan College Of Medicine

• Choi Kee-joon

  Asan Medical Center Department Of Internal Medicine University Of Ulsan College Of Medicine

• Kim Sung-hwan

  Asan Medical Center Department Of Internal Medicine University Of Ulsan College Of Medicine

• Nam Gi-byoung

  Asan Medical Center Department Of Internal Medicine University Of Ulsan College Of Medicine

• Kim Sung-Hwan

  Asan Medical Center, College of Medicine, University of Ulsan

• Kim You-Ho

  Asan Medical Center, College of Medicine, University of Ulsan

• Choi Kee-Joon

  Asan Medical Center, College of Medicine, University of Ulsan

• Ri Kim

  Asan Medical Center, College of Medicine, University of Ulsan

• Kim Yong-Giun

  Asan Medical Center, College of Medicine, University of Ulsan

• Won Hwang

  Asan Medical Center, College of Medicine, University of Ulsan

• Nam Gi-Byoung

  Asan Medical Center, College of Medicine, University of Ulsan

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