Arrhythmias & electrophysiology

2-Hydroxybenzylamine for Treatment of Atrial Fibrillation: A First-in-Human Clinical Pilot Trial

Circ Arrhythm ElectrophysiolPublished first-in-human pilot clinical trial

Primary result · AF recurrence in the postablation population (smartwatch single-lead ECG)Result — go to the resultOdds ratio 3.65 95% CI 1.31–10.16

Authors' conclusion

2-HOBA was associated with a higher risk of AF recurrence when tested early after AF ablation. This result was unexpected based on preclinical data, but paradoxical associations with AF have been previously reported for other drugs that target inflammation and oxidative stress pathways, such as omega-3 fatty acids. The mechanisms for AF immediately following ablation may be different from AF that occurs under other conditions, and the generalizability of these results to all forms of AF remains unknown.

Study context

Population
Patients with a planned atrial fibrillation (AF) ablation
Comparison
2-HOBA vs placebo
Methodological detailsrandomized 1:1, placebo
  • Randomized 1:1
  • Placebo

Primary result

As reported in the abstract

AF recurrence in the postablation population (smartwatch single-lead ECG) · 28 days after ablation

Odds ratio

3.65

95% CI 1.31–10.16

P = 0.013

2-HOBAvs placebo
odds ratio 3.65 (95% CI 1.31–10.16); P = 0.013

Further findings

Isolevuglandin levels · time of ablation

No difference between the 2-HOBA and placebo groups

AF recurrence after study drug stopped · 12-month extended follow-up

No difference between the 2-HOBA and placebo groups

Original publication

2-Hydroxybenzylamine for Treatment of Atrial Fibrillation: A First-in-Human Clinical Pilot Trial. Circ Arrhythm Electrophysiol. Published 25 July 2025. doi:10.1161/circep.124.013378

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