Atorvastatin for prevention of atrial fibrillation recurrence following pulmonary vein isolation: A double-blind, placebo-controlled, randomized trial

Background: It is known that statins are effective in preventing atrial fibrillation (AF) in patients undergoing cardiac surgery. Objective: The purpose of this study was to evaluate the efficacy of statins in preventing AF recurrence following left atrial ablation. Methods: One hundred twenty-five patients who had no statin indication undergoing catheter ablation due to drug-refractory paroxysmal (n = 90) or persistent (n = 35) AF were randomized in a prospective, double-blind, placebo-controlled trial to receive 80 mg atorvastatin (n = 62) or placebo (n = 63) for 3 months. The primary endpoint was freedom from symptomatic AF at 3 months. Secondary endpoints included freedom from any atrial arrhythmia recurrence irrespective of symptoms, quality of life (QoL), and reduction in C-reactive protein (CRP). Results: At 3 months, 95% of patients in the atorvastatin group were free of symptomatic AF compared with 93.5% in the placebo group (P =.75). Similarly, 85% of patients treated in the atorvastatin group remained free of any recurrent atrial arrhythmia vs 88% of patients in the placebo group (P =.37). Mean CRP levels decreased in the atorvastatin group (mean change -0.75 ± 3, P =.02) and increased in the placebo group (mean change 2.1 ± 19.9, P =.48). Mean QoL score improved significantly in both groups (mean change 13.14 ± 18.2 in the atorvastatin group and 11.10 ± 17.7 in the placebo group, P =.53). Conclusion: In patients with no standard indication for statin therapy, treatment with atorvastatin 80 mg/day following AF ablation does not decrease the risk of AF recurrence in the first 3 months and should not be routinely administered to prevent periprocedural arrhythmias.