Abstract 4363825: Colchicine as an Adjunct Therapy Following Catheter Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Background: Atrial fibrillation (AF) recurrence following catheter ablation remains a significant clinical challenge, often attributed to post-procedural inflammation. Colchicine, an anti-inflammatory agent, has emerged as a potential therapeutic strategy to reduce recurrence. This meta-analysis evaluates the efficacy and safety of colchicine in preventing AF recurrence after ablation. Methods: A comprehensive literature search was conducted across PubMed, Embase, Scopus, and Cochrane databases through March 2025. Randomized controlled trials (RCTs) and observational studies assessing colchicine versus control in post-ablation AF patients were included. The primary outcome was AF recurrence; secondary outcomes included pericarditis, hospitalizations, gastrointestinal side effects, and composite clinical events. Data were pooled using a random-effects model, and subgroup and sensitivity analyses were conducted. Results: A total of 10 studies (5 RCTs, 5 observational; N = 3,784) were included. Colchicine significantly reduced AF recurrence (RR = 0.75; 95% CI: 0.57–0.98; P = 0.04). The effect was more pronounced in RCTs (RR = 0.60; 95% CI: 0.45–0.80; P = 0.0004). Colchicine was associated with an increased risk of gastrointestinal side effects (RR = 2.34; 95% CI: 1.21–4.55; P = 0.01) but had no significant effect on pericarditis (RR = 0.62; 95% CI: 0.23–1.70; P = 0.36), hospitalizations, or composite outcomes. Conclusion: Colchicine appears to reduce AF recurrence following catheter ablation, particularly in rigorously conducted RCTs. While gastrointestinal intolerance is a notable concern, colchicine may offer a valuable adjunctive strategy to improve ablation outcomes. Larger, well-powered trials are warranted to confirm these findings and define optimal dosing strategies.