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Predictors of atrial fibrillation recurrence after cryoballoon ablation.

Aksu T, Baysal E, Guler TE, Golcuk SE, Erden İ, Ozcan KS - J Blood Med (2015)

Bottom Line: One hundred and sixty-eight pulmonary veins were used for pulmonary vein isolation with the second-generation cryoballoon.Patients with AF recurrence had higher red cell distribution width levels (16.10%±1.44% vs 14.87%±0.48%, P=0.035).The neutrophil/lymphocyte ratio, erythrocyte sedimentation rate, and C-reactive protein levels were detected in the patients with or without recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Derince Education and Research Hospital, Kocaeli, Turkey.

ABSTRACT

Objective: Cryoballoon ablation (CA) is a safe and efficient method for pulmonary vein isolation in the treatment of paroxysmal atrial fibrillation (AF). There are conflicting results about the predictors of AF recurrence. The aim of this study is to evaluate the role of hematological indices to predict AF recurrence after CA.

Methods: A total of 49 patients (mean age 58.3±12.2 years, 51.02% female) with symptomatic paroxysmal AF underwent CA procedure. One hundred and sixty-eight pulmonary veins were used for pulmonary vein isolation with the second-generation cryoballoon. The hematological samples were obtained before and 24 hours after ablation.

Results: At a mean follow-up of 10.2±2.4 months, the probability of being arrhythmia-free after a single procedure was 86%. Patients with AF recurrence had higher red cell distribution width levels (16.10%±1.44% vs 14.87%±0.48%, P=0.035). The neutrophil/lymphocyte ratio, erythrocyte sedimentation rate, and C-reactive protein levels were detected in the patients with or without recurrence. Left atrial diameter (46.28±4.30 mm vs 41.02±4.10 mm, P=0.002), duration of AF (6.71±4.57 years vs 3.59±1.72 years, P=0.003), and age (65.01±15.39 years vs 54.29±11.32 years, P=0.033) were the other independent predictors of clinical recurrence after CA. Multiple regression analysis revealed that left atrial diameter was the only independent predictor for AF recurrence (P=0.012).

Conclusion: In this study of patients with paroxysmal AF undergoing cryoablation, increased preablation red cell distribution width levels, and not C-reactive protein or erythrocyte sedimentation rate, was associated with a higher rate of AF recurrence. Our results support the role of a preablation, proinflammatory, and pro-oxidant environment in the development of AF recurrence after ablation therapy but suggest that other factors are also important.

No MeSH data available.


Related in: MedlinePlus

Correlation of plasma C-reactive protein (CRP) levels and left atrial (LA) diameter in the patients undergoing atrial fibrillation (AF) ablation procedure.
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f1-jbm-6-211: Correlation of plasma C-reactive protein (CRP) levels and left atrial (LA) diameter in the patients undergoing atrial fibrillation (AF) ablation procedure.

Mentions: We analyzed 49 patients (25 males) with mean age of 54.6±10.7 years and LA diameter size of 41.77±4.49 cm; Ejection fraction of 58.57±5.01; unsuccessful antiarrhythmic drug number of 1.41±0.6; and median European Heart Rhythm Association score of 2. Baseline characteristics and demo-graphical features of the patients are presented in Table 2. After a mean follow-up period of 10.2±2.4 months (range 8–12), early recurrence was observed in 5 (10.2%) patients and late recurrence was observed in 2 (4.08%) patients (Figure 1). The patients with AF recurrence (Group 1) were significantly older (64.59±15.39 vs 54.28±11.32, P=0.033), had larger LA diameters (46.28±4.30 mm vs 41.02±4.10 mm, P=0.002), and had a longer history of AF (6.71±4.57 years vs 3.79±1.72 years, P=0.003) than patients with no recurrence (Group 2). The other baseline demographics were comparable between groups (Table 3).


Predictors of atrial fibrillation recurrence after cryoballoon ablation.

Aksu T, Baysal E, Guler TE, Golcuk SE, Erden İ, Ozcan KS - J Blood Med (2015)

Correlation of plasma C-reactive protein (CRP) levels and left atrial (LA) diameter in the patients undergoing atrial fibrillation (AF) ablation procedure.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492636&req=5

f1-jbm-6-211: Correlation of plasma C-reactive protein (CRP) levels and left atrial (LA) diameter in the patients undergoing atrial fibrillation (AF) ablation procedure.
Mentions: We analyzed 49 patients (25 males) with mean age of 54.6±10.7 years and LA diameter size of 41.77±4.49 cm; Ejection fraction of 58.57±5.01; unsuccessful antiarrhythmic drug number of 1.41±0.6; and median European Heart Rhythm Association score of 2. Baseline characteristics and demo-graphical features of the patients are presented in Table 2. After a mean follow-up period of 10.2±2.4 months (range 8–12), early recurrence was observed in 5 (10.2%) patients and late recurrence was observed in 2 (4.08%) patients (Figure 1). The patients with AF recurrence (Group 1) were significantly older (64.59±15.39 vs 54.28±11.32, P=0.033), had larger LA diameters (46.28±4.30 mm vs 41.02±4.10 mm, P=0.002), and had a longer history of AF (6.71±4.57 years vs 3.79±1.72 years, P=0.003) than patients with no recurrence (Group 2). The other baseline demographics were comparable between groups (Table 3).

Bottom Line: One hundred and sixty-eight pulmonary veins were used for pulmonary vein isolation with the second-generation cryoballoon.Patients with AF recurrence had higher red cell distribution width levels (16.10%±1.44% vs 14.87%±0.48%, P=0.035).The neutrophil/lymphocyte ratio, erythrocyte sedimentation rate, and C-reactive protein levels were detected in the patients with or without recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Derince Education and Research Hospital, Kocaeli, Turkey.

ABSTRACT

Objective: Cryoballoon ablation (CA) is a safe and efficient method for pulmonary vein isolation in the treatment of paroxysmal atrial fibrillation (AF). There are conflicting results about the predictors of AF recurrence. The aim of this study is to evaluate the role of hematological indices to predict AF recurrence after CA.

Methods: A total of 49 patients (mean age 58.3±12.2 years, 51.02% female) with symptomatic paroxysmal AF underwent CA procedure. One hundred and sixty-eight pulmonary veins were used for pulmonary vein isolation with the second-generation cryoballoon. The hematological samples were obtained before and 24 hours after ablation.

Results: At a mean follow-up of 10.2±2.4 months, the probability of being arrhythmia-free after a single procedure was 86%. Patients with AF recurrence had higher red cell distribution width levels (16.10%±1.44% vs 14.87%±0.48%, P=0.035). The neutrophil/lymphocyte ratio, erythrocyte sedimentation rate, and C-reactive protein levels were detected in the patients with or without recurrence. Left atrial diameter (46.28±4.30 mm vs 41.02±4.10 mm, P=0.002), duration of AF (6.71±4.57 years vs 3.59±1.72 years, P=0.003), and age (65.01±15.39 years vs 54.29±11.32 years, P=0.033) were the other independent predictors of clinical recurrence after CA. Multiple regression analysis revealed that left atrial diameter was the only independent predictor for AF recurrence (P=0.012).

Conclusion: In this study of patients with paroxysmal AF undergoing cryoablation, increased preablation red cell distribution width levels, and not C-reactive protein or erythrocyte sedimentation rate, was associated with a higher rate of AF recurrence. Our results support the role of a preablation, proinflammatory, and pro-oxidant environment in the development of AF recurrence after ablation therapy but suggest that other factors are also important.

No MeSH data available.


Related in: MedlinePlus