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Single-Dose Intraprocedural Steroid Administration Does Not Impact Early Atrial Fibrillation Recurrence

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Abstract

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.

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We the authors have disclosed all potential conflicts of interest. Our research does involve human participants who have consented to have their medical data used for research purposes. Our research does not involve animal subjects.

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Acknowledgements

All participating parties have been adequately acknowledged.

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Authors and Affiliations

  1. Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Kolade M. Agboola, Michael Dietrich, Roshan Karki, Fahad Lodhi, Trevon McGill, Samuel J. Asirvatham, Abhishek J. Deshmukh & Christopher V. DeSimone

  2. Division of Cardiovascular Disease, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Kolade M. Agboola, Michael Dietrich, Roshan Karki, Fahad Lodhi, Trevon McGill, Samuel J. Asirvatham, Abhishek J. Deshmukh & Christopher V. DeSimone

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  1. Kolade M. Agboola
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  2. Michael Dietrich
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  3. Roshan Karki
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  4. Fahad Lodhi
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  5. Trevon McGill
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  6. Samuel J. Asirvatham
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  7. Abhishek J. Deshmukh
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  8. Christopher V. DeSimone
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Drs. Kolade M. Agboola, Michael Dietrich, Roshan Karki, and Christopher V. DeSimone. The first draft of the manuscript was written by Dr. Kolade M. Agboola and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Christopher V. DeSimone.

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Appropriate IRB approval was obtained for conducting this study.

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Each patient provided generalized consent to participate in the research, which encompasses publication in an academic journal.

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The authors declare no competing interests.

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Agboola, K.M., Dietrich, M., Karki, R. et al. Single-Dose Intraprocedural Steroid Administration Does Not Impact Early Atrial Fibrillation Recurrence. Cardiovasc Drugs Ther 37, 151–157 (2023). https://doi.org/10.1007/s10557-021-07271-2

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  • DOI: https://doi.org/10.1007/s10557-021-07271-2

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