Effect of a single bolus injection of low-dose hydrocortisone for prevention of atrial fibrillation recurrence after radiofrequency catheter ablation

Background: The transient use of corticosteroid shortly after atrial fibrillation (AF) ablation might prevent immediate and mid-term AF recurrence; however, the effective dosage for preventing AF recurrence has not been determined. In this study, we evaluated whether low-dose hydrocortisone is effective for the prevention of AF recurrence after radiofrequency catheter ablation (RFCA). Methods and Results: We enrolled 89 AF patients (70 males, 55.8±10.9 years) who underwent RF ablation and were treated with single bolus injection of 100 mg hydrocorticosteroid (corticosteroid group). For the control group, we enrolled 120 sex- and age-matched AF patients (94 males, 55.4±10.5 years). Pericarditis occurred in 3 (2.5%) and 1 (1.1%) patients in the control and corticosteroid groups, respectively. The number of patients with immediate AF recurrence (≤2 days) was 17 (14.5%) and 11 (12.4%) in the control and steroid groups, respectively (P=0.687). Treatment with low-dose steroid did not decrease early (3-30 days) AF recurrence (13 [11.1%] vs. 11 [12.5%], P=0.829) or late (≥31 days) AF recurrence after ablation (26 [22.2%] vs. 13 [14.6%], P=0.209). There was no difference in cumulative survival free of late AF recurrence between the corticosteroid and control groups (P=0.57 by log-rank test). White blood cell count, C-reactive protein concentration and maximum body temperature also were unchanged by low-dose steroid. Conclusions: Single bolus injection of low-dose hydrocortisone after AF ablation is not effective for preventing AF recurrence during the mid-term follow-up period.