TY - JOUR
T1 - Use of oral steroid and its effects on atrial fibrillation recurrence and inflammatory cytokines post ablation - The steroid af study
AU - Iskandar, Sandia
AU - Reddy, Madhu
AU - Afzal, Muhammad R.
AU - Rajasingh, Johnson
AU - Atoui, Moustapha
AU - Lavu, Madhav
AU - Atkins, Donita
AU - Bommana, Sudha
AU - Umbarger, Linda
AU - Jaeger, Misty
AU - Pimentel, Rhea
AU - Dendi, Raghuveer
AU - Emert, Martin
AU - Turagam, Mohit
AU - Di Biase, Luigi
AU - Natale, Andrea
AU - Lakkireddy, Dhanunjaya
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Use of corticosteroids before and after atrial fibrillation (AF) ablation can decrease acute inflammation and reduce AF recurrence.To assess the efficacy of oral prednisone in improving the outcomes of pulmonary vein isolation with radiofrequency ablation and its effect on inflammatory cytokines, a total of 60 patients with paroxysmal AF undergoing radiofrequency ablation were randomized (1:1) to receive either 3 doses of 60 mg daily of oral prednisone or a placebo. Inflammatory cytokine levels (TNF-α, IL-1, IL6, IL-8) were measured at baseline, prior to ablation, immediately after ablation, and 24 hours post ablation. Patients underwent 30 day event monitoring at 3 months, 6 months and 12 months post procedure. Immediate post ablation levels of inflammatory cytokines were lower in the steroid group when compared to the placebo group; IL-6:9.0 ±7 vs 15.8 ±13 p=0.031; IL-8:10.5 ±9 vs 15.3 ±8; p=0.047 respectively. Acute PV reconnection rates during the procedure (7/23% vs 10/36%; p = 0.39), and RF ablation time (51±13 vs 56±11 min, p = 0.11) trended to be lower in the placebo group than the steroid group. There was no difference in the incidence of early recurrence of AF during the blanking period and freedom from AF off AAD at 12 months between both groups (5/17% vs 8/27%; p = 0.347 and 21/70% vs 18/60%; p=0.417 in placebo and steroid groups respectively). CONCLUSION: Although oral corticosteroids have significant effect in lowering certain cytokines, it did not impact the clinical outcomes of AF ablation.
AB - Use of corticosteroids before and after atrial fibrillation (AF) ablation can decrease acute inflammation and reduce AF recurrence.To assess the efficacy of oral prednisone in improving the outcomes of pulmonary vein isolation with radiofrequency ablation and its effect on inflammatory cytokines, a total of 60 patients with paroxysmal AF undergoing radiofrequency ablation were randomized (1:1) to receive either 3 doses of 60 mg daily of oral prednisone or a placebo. Inflammatory cytokine levels (TNF-α, IL-1, IL6, IL-8) were measured at baseline, prior to ablation, immediately after ablation, and 24 hours post ablation. Patients underwent 30 day event monitoring at 3 months, 6 months and 12 months post procedure. Immediate post ablation levels of inflammatory cytokines were lower in the steroid group when compared to the placebo group; IL-6:9.0 ±7 vs 15.8 ±13 p=0.031; IL-8:10.5 ±9 vs 15.3 ±8; p=0.047 respectively. Acute PV reconnection rates during the procedure (7/23% vs 10/36%; p = 0.39), and RF ablation time (51±13 vs 56±11 min, p = 0.11) trended to be lower in the placebo group than the steroid group. There was no difference in the incidence of early recurrence of AF during the blanking period and freedom from AF off AAD at 12 months between both groups (5/17% vs 8/27%; p = 0.347 and 21/70% vs 18/60%; p=0.417 in placebo and steroid groups respectively). CONCLUSION: Although oral corticosteroids have significant effect in lowering certain cytokines, it did not impact the clinical outcomes of AF ablation.
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U2 - 10.4022/jafib.1604
DO - 10.4022/jafib.1604
M3 - Article
AN - SCOPUS:85017555292
VL - 9
JO - Journal of Atrial Fibrillation
JF - Journal of Atrial Fibrillation
SN - 1941-6911
IS - 5
ER -