Key result
Single-dose intraoperative IV dexamethasone fails to reduce early AF recurrence compared to no steroids.
Why the study?
The study was conducted to evaluate the effect of single-dose intravenous dexamethasone on AF recurrence following radiofrequency catheter ablation.
Does single-dose intraoperative intravenous dexamethasone reduce atrial fibrillation recurrence in adult patients undergoing first-time catheter ablation for atrial fibrillation?
Cohort (n=94)
Operator blinded
No
Does single-dose intraoperative intravenous dexamethasone reduce atrial fibrillation recurrence in adult patients undergoing first-time catheter ablation for atrial fibrillation?
Absolute Event Rate: 20.6% vs 21.7%
p-value: p=1.00
Single-dose intraoperative intravenous dexamethasone administered for postoperative nausea and vomiting prophylaxis does not significantly impact early or late atrial fibrillation recurrence rates following catheter ablation.
Dexamethasone for PONV prophylaxis was not associated with early AF recurrence after ablation; leaves open any effect on ablation outcomes.
Purpose : To evaluate the effect of single-dose intravenous dexamethasone on AF recurrence following radiofrequency catheter ablation. Methods: A cohort of 94 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 at less than 3 months or between 3 months and 1 year with an in-person follow-up visit. Results: A total of 36.2% of patients received intravenous dexamethasone compared to 63.8% who did not (providing a 2:1 comparison group). The incidence of documented AF or flutter lasting greater than 30 seconds was 20.6% in the dexamethasone group versus 21.7% in the non-dexamethasone group, p value 1.00. AF or atrial flutter recurrence from 3 months to 1 year was 20.6% in the dexamethasone group compared to 21.7% in the non-dexamethasone group, p value 1.00. Conclusion: These data suggest that intraoperative intravenous dexamethasone administered during AF ablation for postoperative nausea and vomiting prophylaxis does not have a significant effect on AF recurrence rates.
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Agboola et al. (2021) conducted a cohort in Atrial fibrillation undergoing catheter ablation (n=94). Intravenous dexamethasone vs. No intravenous steroids was evaluated on Early atrial fibrillation or atrial flutter recurrence (<3 months) (p=1.00). Single-dose intraoperative intravenous dexamethasone did not significantly affect early atrial fibrillation recurrence rates compared to no steroids (20.6% vs 21.7%, p=1.00).
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