| Prevention of atrial fibrillation recurrence with corticosteroids after radiofrequency catheter ablation: a randomized controlled trial. | |
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MedLine Citation:
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PMID: 20951321 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We sought to clarify the efficacy of corticosteroid therapy for preventing atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). BACKGROUND: The inflammatory process may cause acute AF recurrence after PVI. However, no studies have examined the relationship between corticosteroid administration and AF recurrence after PVI. METHODS: A total of 125 patients with paroxysmal AF were randomized to receive either corticosteroids (corticosteroid group) or a placebo (placebo group). In the corticosteroid group, intravenous hydrocortisone (2 mg/kg) was given the day of the procedure, and oral prednisolone (0.5 mg/kg/day) was administered for 3 days after the PVI. The body temperature and high-sensitivity C-reactive protein level were measured before and on each of the first 3 days after ablation. RESULTS: The prevalence of immediate AF recurrence (≤3 days after the PVI) was significantly lower in the corticosteroid group (7%) than in the placebo group (31%). The maximum body temperature and C-reactive protein during the initial 3 days after ablation and the increase in the body temperature and C-reactive protein level from baseline were significantly lower in the corticosteroid group than in the placebo group. Corticosteroid treatment did not decrease AF recurrences between 4 and 30 days after ablation. The AF-free rate at 14 months post-ablation was greater in the corticosteroid group (85%) than in the placebo group (71%, p=0.032 by the log-rank test). CONCLUSIONS: Transient use of small amounts of corticosteroids shortly after AF ablation may be effective and safe for preventing not only immediate AF recurrences but also AF recurrences during the mid-term follow-up period after PVI. |
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Authors:
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Takashi Koyama; Hiroshi Tada; Yukio Sekiguchi; Takanori Arimoto; Hiro Yamasaki; Kenji Kuroki; Takeshi Machino; Kazuko Tajiri; Xu Dong Zhu; Miyako Kanemoto-Igarashi; Aiko Sugiyasu; Keisuke Kuga; Yoshio Nakata; Kazutaka Aonuma |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 56 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-18 Completed Date: 2010-11-02 Revised Date: 2011-05-24 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1463-72 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan. tkoyama-tym@umin.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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therapeutic use* Aged Atrial Fibrillation / drug therapy, prevention & control*, surgery Catheter Ablation* Double-Blind Method Female Follow-Up Studies Humans Male Middle Aged Prospective Studies Recurrence / prevention & control Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2010 Oct 26;56(18):1473-5
[PMID:
20951322
]
J Am Coll Cardiol. 2011 Apr 12;57(15):1638; author reply 1638-9 [PMID: 21474049 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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