Introduction:
Catheter ablation for restoration of sinus rhythm is limited by the high rates of arrhythmia due to inflammation caused by the procedure. Colchicine, a microtubule polymerisation inhibitor, reduces inflammation and may decrease atrial arrhythmia recurrence. We conducted a meta-analysis of RCTs and observational studies to assess the efficacy of colchicine in reducing atrial fibrillation (A fib) recurrence and pericarditis.

Methods:
We identified seven studies through the systematic search of the PubMed, Embase, and Cochrane databases from inception to March 2024. Eligible articles had to be RCTs or observational studies comparing the effectiveness of colchicine with placebo in patients who underwent catheter ablation. Outcomes included A fib recurrence, atrial tachycardia, need to perform cardioversion or re-ablation, gastrointestinal (GI) adverse effects, pericarditis, and repeat hospitalisation. A random effects model was used to analyse binary outcomes, and the Mantel-Haenszel method was used to calculate the odds ratio with a 95% confidence interval.

Results:
Data from 2165 patients were analysed. Colchicine reduced A fib OR = 0.61 (p = 0.001), pericarditis OR = 0.54 (p = 0.07), and the need for re-ablation OR = 0.53 (p = 0.36). However, it increased GI adverse effects OR = 3.15 (p = 0.008). There was no statistical difference in the need for cardioversion, repeat hospitalisation, and atrial tachycardia between the two groups.

Conclusions:
Although colchicine significantly reduced the recurrence of A fib, further investigation is needed for a comprehensive understanding of the efficacy of colchicine in patients with catheter ablation.