背景:导管消融已成为一种广泛接受的心房颤动治疗方法,但是早期复发仍然是一个挑战,通常归因于手术过程中引发的炎症反应。本系统评价和荟萃分析旨在评估秋水仙碱预防消融后短期房颤复发的有效性。
方法:PubMed,Embase,我们在Cochrane图书馆中搜索了对房颤消融术后患者使用秋水仙碱和安慰剂的比较研究。结果包括房颤复发,胃肠道副作用,和住院。采用R程序(4.3.2版)进行统计分析。用I2统计量评估异质性。
结果:五项研究,包括1592名病人,进行了分析。汇总结果显示,使用秋水仙碱后,房颤复发率(OR0.74;95%CI0.48-1.12;p=0.153)和心包炎发生率(OR0.67;95%CI0.26-1.72;p=0.403)无统计学显着降低。秋水仙碱组和安慰剂组住院率无显著差异(OR1.00;95%CI0.63-1.59;p=0.996)。此外,秋水仙碱组的胃肠道副作用明显更高(OR4.84;95%CI2.58-9.05;p<0.001)。
结论:心房消融术后预防性使用秋水仙碱与降低房颤复发率和心包炎发生率无关。此外,两组之间的全因住院率没有差异,使用秋水仙碱与胃肠道不良事件相关.
BACKGROUND: Catheter ablation has become a widely accepted treatment for atrial fibrillation, but early recurrences remain a challenge, often attributed to inflammatory responses triggered during the procedure. This systematic review and meta-analysis aimed to evaluate the effectiveness of colchicine in preventing short-term AF recurrence post-ablation.
METHODS: PubMed, Embase, and Cochrane Library were searched for studies comparing use of colchicine and placebo in patients after AF ablation. Outcomes included AF recurrence, GI side effects, and hospitalization. R program (version 4.3.2) was used for statistical analysis. Heterogeneity was assessed with I2 statistics.
RESULTS: Five studies, including 1592 patients, were analyzed. Pooled results revealed no statistically significant decrease in AF recurrence (OR 0.74; 95% CI 0.48-1.12; p = 0.153) and pericarditis rates (OR 0.67; 95% CI 0.26-1.72; p = 0.403) with colchicine use. No significant difference in hospitalization rates was observed between colchicine and placebo groups (OR 1.00; 95% CI 0.63-1.59; p = 0.996). In addition, gastrointestinal side effects were notably higher in the colchicine group (OR 4.84; 95% CI 2.58-9.05; p < 0.001).
CONCLUSIONS: Prophylactic use of colchicine after atrial ablation was not associated with a reduction in AF recurrence and pericarditis rates. In addition, there was no difference in the rate of all-cause hospitalization between the groups, and colchicine use was associated with gastrointestinal adverse events.