Prophylactic colchicine to reduce VOM ethanol infusion related Pericarditis

Pulmonary vein isolation (PVI) is an established treatment for atrial fibrillation (AF) [1], but for persistent AF PVI appears to be suboptimal and any kind of additional lesion has been proven to not enhance the efficacy of the ablation [2-3]. In this setting, the Vein of Marshall ethanol infusion (VOM-EI) has been proven to reduce recurrences of AF 12 months [4]. The VOM-EI has been proven to cause up to 2,8% of procedure-related pericarditis in a large cohort of 700 patients [5].

Evaluate the effects of colchicine in VOM-EI related pericarditis reduction.

We retrospectively analyzed the incidence of pericarditis in a cohort of consecutive patients with persistent AF without an history of previous ablation who underwent single day discharge VOM-EI 30 days before the ablation procedure according to our center protocol.

We enrolled 63 patients (71.1% male, 65±6.8 years). In the first 44 (69,8%) the incidence of pericarditis was 4,5% as compared to the next 19 (30,2%) patients, who started to receive prophylactic colchicine (as for our Centre protocol update, 1 day before and 7 days after VOM-EI), who did not experienced pericarditis.

Our data show that prophylactic colchicine treatment in patients undergoing VOM-EI is promising in reducing the incidence of procedure related pericarditis.

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