Indian Pacing and Electrophysiology Journal | 2019
Predictors of the paroxysmal atrial fibrillation recurrence following cryoballoon-based pulmonary vein isolation: Assessment of left atrial volume, left atrial volume index, galectin-3 level and neutrophil-to-lymphocyte ratio
Abstract
Background Cryoballoon-based pulmonary vein isolation (PVI) is a treatment option for atrial fibrillation (AF). Left atrial volume (LAV) and left atrial volume index (LAVi) are important parameters for long term success of PVI. Galectin-3 (Gal-3) and neutrophil to lymphocyte ratio (N/L ratio) are biomarkers to demonstrate the cardiac fibrosis and remodelling. Methods 50 patients with symptomatic PAF despite ≥1 antiarrhythmic drug(s), who underwent PVI were enrolled. LAV, LAVi, Gal-3 and N/L ratio were calculated before ablation and after ablation at 6 and 12 months. According to AF recurrence patients were divided into two groups, recurrent AF (n\u202f=\u202f14) and non-recurrent AF (n\u202f=\u202f36). Results In both groups (recurrent and non-recurrent), initial and 12 months follow-up LAV values were 41.39\u202f±\u202f18.13\u202fml and 53.24\u202f±\u202f22.11\u202fml vs 48.85\u202f±\u202f12.89\u202fml and 42.08\u202f±\u202f13.85 (p\u202f=\u202f0.037). LAVi were 20.9\u202f±\u202f8.91 ml/m2 and 26.85\u202f±\u202f11.28 ml/m2 vs 25.36\u202f±\u202f6.21 and 21.87\u202f±\u202f6.66 (p\u202f=\u202f0.05) for recurrent and non-recurrent AF groups, respectively. In both groups PVI had no significant effect on serum Gal-3 levels and N/L ratio during 12 months follow-up. The comparison between two groups at the end of 12th month showed Gal-3 values of 6.66\u202f±\u202f4.09\u202fng/ml and 6.02\u202f±\u202f2.95\u202fng/ml (p\u202f=\u202f0.516), N/L ratio values of 2.28\u202f±\u202f1.07 103/μl and 1.98\u202f±\u202f0.66\u202f103/μl (p\u202f=\u202f0.674). Conclusion LAV and LAVi are useful to predict the remodelling of the left atrium and AF recurrence after cryoballoon-based PVI. However, biomarkers such as Gal-3 and N/L ratio are not associated with AF recurrence.