No clear benefit was observed for AF recurrence at 2 - 3 days , 1 or 24 months of follow-up .
Steroid use was associated with decreased risk of early AF recurrence 3 and 12 - 14 months after ablation .
Previous studies have reported that steroids may reduce the risk of  atrial fibrillation ( AF ) recurrence after catheter ablation , but data regarding this issue have been controversial .
Therefore , we conducted a meta- analysis of r and omized clinical trials ( RCTs ) and observational studies to ascertain the association of steroids and  AF recurrence  after ablation .
Corticosteroid use during pulmonary vein isolation is associated with a higher prevalence of dormant pulmonary vein conduction.
BACKGROUND Atrial fibrillation ( AF ) recurrence after pulmonary vein isolation ( PVI ) is associated with PV to left atrium reconduction . OBJECTIVE The purpose of this study was to prospect ively determine if the use of intraprocedural corticosteroids to limit the extent of tissue edema and /or inflammation alters the prevalence of spontaneous and adenosine-induced acute PV reconnection after PVI . METHODS Prior to wide circumferential PVI , 45 patients received a single intravenous ( IV ) bolus of hydrocortisone 250 mg immediately after transseptal access ( steroid group ) . Another 45 consecutive patients underwent st and ard PVI without IV hydrocortisone  ( nonsteroid group ) . After PVI , all patients underwent adenosine testing to unmask dormant conduction . Patients were followed at 3 , 6 , and 12 months . RESULTS Dormant conduction was unmasked in a significantly higher proportion of PVs in the steroid group compared with the nonsteroid group ( 32.8 % of PVs [ 60/183 ] vs 21.1 % of PVs [ 37/175 ] , P = .03 ) . On multivariate generalized estimating equation analysis , steroid use remained independently associated with dormant PV conduction ( P = .03 ) . There was no difference in the segmental distribution of reconnection between the 2 groups . The 1-year freedom from recurrent AF did not differ between groups ( P = .37 ) . Radiofrequency time was significantly longer in the steroid group ( 58 ± 21 minutes vs 48 ± 18 minutes , P < .01 ) , whereas procedure duration and fluoroscopy time were comparable ( P = .55 and P = .44 , respectively ) . CONCLUSION A single bolus of hydrocortisone 250 mg IV prior to PVI results in greater radiofrequency requirements for PVI and a higher prevalence of dormant PV conduction unmasked by adenosine . The utility of these approaches requires evaluation in a long-term prospect i ve r and omized study
No clear benefit was observed for AF recurrence at 2 - 3 days , 1 or 24 months of follow-up .
Steroid use was associated with decreased risk of early AF recurrence 3 and 12 - 14 months after ablation .
Previous studies have reported that steroids may reduce the risk of  atrial fibrillation ( AF ) recurrence after catheter ablation , but data regarding this issue have been controversial .
Therefore , we conducted a meta- analysis of r and omized clinical trials ( RCTs ) and observational studies to ascertain the association of steroids and  AF recurrence  after ablation .