Effect of hydrocortisone on the recurrence of atrial fibrillation after radiofrequency ablation

Wang Shao-ya

doi:10.3969/j.issn.1002-1949.2017.03.013

Abstract：Objective To evaluate the efficacy of hydrocortisone in the prevention of recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA).Methods A total of 256 RFCA patients were randomly divided into hydrocortisone group and control group,each group consisted of 128 patients.Patients in the hydrocortisone group were treated with 100 mg hydrocortisone injection in 100 mL 5％ glucose injection after RFCA,intravenous infusion once a day for 3 ～ 6 days.Patients in the control group were not injected with corticosteroids.Body temperature (BT),C-reactive protein (CRP),white blood cell count (WBC) and the incidence of pericarditis in two groups after treatment with hydrocortisone were observed and compared.The patients were followed up for one year,and AF recurrence rates were compared between the two groups.Multivariate Cox regression analysis was used to evaluate independent prognostic factors associated with AF recurrence.Results There was no significant difference in WBC,CRP,BT and the incidence of pericarditis between the hydrocortisone group and the control group (all P ＞0.05).The immediate recurrence [8 (6.7％) vs.19 (14.8％),P =0.01] and early recurrence [(5 (3.9％)vs.14 (10.9％),P =0.03] of hydrocortisone group were lower than those in the control group.There was no significant difference in the proportion of patients with intermediate recurrence and AF recurrence within 12 months in hydrocortisone group and control group (all P ＞ 0.05).There was no significant difference between the two groups in maintaining sinus rhythm (P=0.58).Multivariate Cox regression analysis showed that persistent AF was an independent predictor of AF recurrence (OR =2.88,95％ CI 1.34 ～6.21,P ＜ 0.01).Conclusion The use of hydrocortisone alone in patients with atrial fibrillation after RF-CA to prevent recurrence of atrial fibrillation is associated with a significantly lower rate of early AF recurrence,but the intermediate recurrence rate of AF does not improve significantly.