Single-Dose Intraprocedural Steroid Administration Does Not Impact Early Atrial Fibrillation Recurrence,Cardiovascular Drugs and Therapy

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Single-Dose Intraprocedural Steroid Administration Does Not Impact Early Atrial Fibrillation Recurrence
Cardiovascular Drugs and Therapy ( IF 3.1 ) Pub Date : 2021-09-28 , DOI: 10.1007/s10557-021-07271-2
Kolade M Agboola _{1,

2} , Michael Dietrich _{1,

2} , Roshan Karki _{1,

2} , Fahad Lodhi _{1,

2} , Trevon McGill _{1,

2} , Samuel J Asirvatham _{1,

2} , Abhishek J Deshmukh _{1,

2} , Christopher V DeSimone _{1,

2}

Affiliation

Purpose

To evaluate the effect of single-dose intravenous dexamethasone on atrial fibrillation (AF) recurrence following radiofrequency catheter ablation.

Methods

A cohort of 84 adult patients (> 18 years) underwent catheter ablation at Mayo Clinic Rochester from January to March 2019. Only first-time ablation patients were included, with all re-do ablations excluded to minimize heterogeneity. Administration of intraoperative dexamethasone 4 mg or 8 mg was determined by chart review from the procedure. At our institution, intraoperative intravenous steroids are administered for postoperative nausea and vomiting (PONV) prophylaxis at the discretion of the anesthesiologist. AF recurrence was determined by ECG or cardiac monitoring within 3 months or between 3 and 12 months post-ablation with an in-person follow-up visit.

Results

A total of 31 (36.9%) patients received intravenous dexamethasone compared to 54 (63.1%) who did not (approximating a 2:1 comparison group). The incidence of documented AF or atrial flutter, lasting greater than 30 s, within the first 3 months post-ablation was 29.0% in the dexamethasone group versus 24.5% in the non-dexamethasone group (p value 0.80). AF or atrial flutter recurrence at 3–12 months post-ablation was 3.2% in the dexamethasone group compared to 9.4% in the non-dexamethasone group (p value 0.41).

Conclusion

These data suggest that intraoperative intravenous dexamethasone administered during AF ablation for postoperative nausea and vomiting prophylaxis may not have a significant effect on AF recurrence rates.

中文翻译：

单剂量术中类固醇给药不会影响早期心房颤动的复发

目的

评估单剂量静脉注射地塞米松对射频导管消融术后心房颤动 (AF) 复发的影响。

方法

2019 年 1 月至 3 月，84 名成年患者（> 18 岁）在 Mayo Clinic Rochester 接受了导管消融术。仅包括首次消融患者，排除所有再次消融以最大限度地减少异质性。术中地塞米松 4 mg 或 8 mg 的给药是根据手术过程中的图表审查确定的。在我们的机构，麻醉师会酌情给予术中静脉内类固醇以预防术后恶心呕吐 (PONV)。房颤复发是通过心电图或心脏监测在消融后 3 个月内或在消融后 3 至 12 个月之间进行的亲自随访来确定的。

结果

共有 31 名 (36.9%) 患者接受了静脉注射地塞米松，而 54 名 (63.1%) 患者未接受静脉注射地塞米松（大约 2:1 的对照组）。在消融后的前 3 个月内，记录到的 AF 或心房扑动持续时间超过 30 秒的发生率在地塞米松组为 29.0%，而在非地塞米松组为 24.5%（p 值 0.80 ）。消融后 3-12 个月的 AF 或心房扑动复发率在地塞米松组为 3.2%，而在非地塞米松组为 9.4%（p值 0.41）。