The Efficacy Of High-dose Atorvastatin On Early Recurrence After Catheter Ablation For Paroxysmal Atrial Fibrillation

Background and objectives Circumferential pulmonary vein isolation (CPVI) has become a major treatment of atrial fibrillation (AF). However, the post-procedural early recurrence rate is still high, which may be related to postoperative inflammatory reaction. With pleiotropic effects, statins are expected to inhibit the inflammatory response and thus reduce the AF recurrence after catheter ablation. We sought to clarify the efficacy of a large dose of atorvastatin therapy for preventing early AF recurrence after CPVI.Methods A total of 40 patients with paroxysmal AF were randomized divided into 2 groups: control group (n=20) and high-dose atorvastatin intervention group (intervention group, n=20). Both groups received routine clinical medical treatment, and control group can only received atorvastatin of≤20mg/d if indicated, and intervention group were given atorvastatin 80mg 24h and 40mg 2h before CPVI, and then atorvastatin 40mg/day for 1 month. Blood samples were collected 24h before and immediately after, 3 days and 1, 2, and 3 months after CPVI. The inflammatory markers including high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α), and myocardial injury markers CK-MB and cTn-T were measured. The Af early recurrence was monitored clinically and by Holter monitoring.Results At a mean follow-up period of 3 months, as compared with the control group, AF burden was significantly reduced in the intervention group (P < 0.05), but there was no statistical difference on the rate of early recurrence between the two groups (P > 0.05). The level of inflammatory markers including hs-CRP, IL-6, TNF-αwere increased immediately and 3 days after ablation in both groups. However, compared with those of the control group, the levels of hs-CRP, IL-6 and TNF-αwere significantly reduced in intervention group (P < 0.05). As compared to baseline, ablation induced mild CK-MB (P < 0.05) and cTn-T (P < 0.05) elevations in both groups with similar elevations between the two groups (P > 0.05, each).Conclusions The study showed that high-dose atorvastatin pretreatment and short-term enhanced intervention can reduce the peri-procedural inflammatory response and atrial fibrillation burden after catheter ablation, but can not decrease the early recurrence of atrial fibrillation.