Colchicine Increases Ventricular Vulnerability in an Experimental Whole‐Heart Model

Abstract

The traditional gout medication colchicine has been reported to effectively prevent atrial fibrillation recurrence after atrial fibrillation ablation or cardiac surgery in a few clinical trials. Severe adverse events have not yet been reported. The aim of the present study was to assess possible direct electrophysiological effects in an experimental whole-heart model. Ten rabbit hearts were isolated and Langendorff-perfused. Thereafter, colchicine was administered in two concentrations (1 and 3 μM). Eight endo- and epicardial monophasic action potentials and a 12-lead ECG showed a stable QT interval and action potential duration during colchicine infusion. Furthermore, there was no significant increase in dispersion of repolarization. However, colchicine induced a dose-dependent significant decrease of effective refractory period (ERP; 1 μM: -19 ms, 3 μM: -22 ms; p < 0.05). In the present study, acute infusion of colchicine in isolated rabbit hearts resulted in a reduction of ERP in the presence of a stable myocardial repolarization. This led to a significantly elevated inducibility of ventricular fibrillation. In 4 of 10 hearts, incessant ventricular fibrillation occurred. These results suggest a pro-arrhythmic or toxic effect of colchicine and underline that further clinical studies on potential adverse effects should be conducted before the drug can be recommended for routine use after atrial fibrillation ablation.

2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

“…However, it, too, should be used with caution in patients with severe renal dysfunction and is contraindicated in patients on dialysis. An increase in ventricular vulnerability was shown in experimental models 826 …”

Colchicine in atrial fibrillation: are old trees in bloom?

“…The efficacy of colchicine is significantly affected by the interruption rate of treatment. A study confirmed that using colchicine to treat cardiovascular disease increased the risk of adverse gastrointestinal reactions and myalgia but has no significant relationship with other adverse reactions ( Frommeyer et al, 2017 ). In addition, acute infusion of colchicine can increase the incidence of ventricular tachyarrhythmias in cardiac models ( Kirchhof et al, 2016 ).…”

Is There a Role for Colchicine in Acute Coronary Syndromes? A Literature Review

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