The Effect of Short-Term Steroid Therapy for Preventing Atrial Tachyarrhythmias in Blanking Period after Catheter-Ablation of Atrial Fibrillation

Background: Atrial arrhythmias occurring during the first 6-12 weeks (blanking period) after ablation of atrial fibrillation (AF) can be highly symptomatic and often require an anti-arrhythmic drug (AAD), cardioversion or hospitalization. Objectives: The anti-inflammatory effect of corticosteroid may suppress atrial arrhythmias during blanking period. Methods: We prospectively enrolled 83 patients were randomly assigned to 2 groups (steroidand control group). The primary end point was hospitalization (ER visit, re-admission) and cardioversion or AAD administration. Secondary end points were atrial tachyarrhythmias or severe symptomatic PAC on holter monitoring in 1 month of the ablation. Result: During follow-up (median, 28.2 days), A total of 15 patients were hospitalized due to recurrent atrial tachyarrhythmias and cardioversion. There was no significant different in hospitalization and cardioversion between the two groups (23.7% vs 13.3% at a months; P=0.26). But the incidence of AAD administration to control symptomatic atrial arrhythmia was significantly lower in steroid group then control (31.6% vs. 84.4% at a month; P<0.0001). After adjusting clinical and procedural characteristics, short-term steroid administration was independently associated with lower rate of atrial arrhythmia on holter monitoring (adjusted HR 0.08, 95% CI 0.02-0.37, p=0.001). Conclusion: Our data suggest that use of peri-procedural short-term corticosteroid significantly reduced the incidence of atrial tachyarrhythmias and AAD administration during blanking period after ablation of AF.