Introduction: The outcomes of Catheter Ablation (CA) and antiarrhythmic drugs (AAD) as the first-line treatment of paroxysmal Atrial Fibrillation (AF) are unclear. The current systematic review reports the evidence on efficacy outcomes of Radiofrequency Ablation (RFA) versus antiarrhythmic drugs (AAD) among these patients. Methods: Three databases, including PubMed, Cochrane, and Google Scholar, were searched by three independent reviewers to identify relevant randomized control trials (RCTs). Results: A total of 1,145 patients across five studies were assessed in this systematic review. Among these patients, 577 were randomized to receive ablation, and 568 were randomized to receive AAD. The recurrence rate was significantly higher among patients who received AAD at 1-year and 2-year follow-ups. The health-related quality of life (HR-QoL) was significantly better in the patients who received ablation therapy. The incidence of serious adverse events was 14 (6.4%) in the ablation group and 9 (4.3%) in the AAD group. Conclusion: CA seems promising for managing AF in terms of any AF recurrence, hospitalization, and quality of life. There was no increase in side effects compared to AAD.

Background: Colchicine is one of many drugs being repurposed for COVID-19 due to its potential as an anti-inflammatory agent alongside its easy accessibility and oral administration. This study aims to identify the risk reduction in mortality and mechanical ventilation of colchicine-treated COVID-19 patients compared to the standard of care/placebo. Methods: A systematic search was conducted until December 31, 2021, with keywords including Colchicine, COVID-19, SARS-CoV-2, anti-inflammatory, trials, clinical, mechanical ventilation, death, and mortality. Databases including MEDLINE/PubMed, Scopus, Web of Science, CINAHL Plus, Cochrane, WHO Global Database, and Preprint servers were searched. Using dichotomous data for all values, the risk ratios (RR) were calculated by applying the random-effects model in Review Manager 5.4. Results: The 12 studies pooled 17,297 participants, with 8,528 patients in the colchicine group and 8,769 in the standard care group. Colchicine treatment led to a statistically significant reduction in the risk of death (RR=0.63, 95% CI=0.48-0.84, P=0.001). Moderately high heterogeneity was present among the included studies (I2=72%). While insignificant, the risk of mechanical ventilation was decreased by 12% among the colchicine group (RR=0.88, 95% CI=0.64-1.22, P=0.44). Conclusions: While this meta-analysis finds overall reductions in mortality with colchicine treatment, these findings must be utilized with caution. Placebo-controlled randomized clinical trials are warranted at a large scale to validate the viability of colchicine as an adjuvant treatment for COVID-19. On obtaining more concrete findings, the potential role of colchicine may be better optimized in non-severe patients as well, across in-hospital and outpatient settings.