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Comparative Study
. 2020 Jun;31(6):1315-1322.
doi: 10.1111/jce.14475. Epub 2020 Apr 17.

Comparison of myocardial injury and inflammation after pulmonary vein isolation for paroxysmal atrial fibrillation between radiofrequency catheter ablation and cryoballoon ablation

Masamichi Yano  1 , Yasuyuki Egami  1 , Kyosuke Yanagawa  1 , Hitoshi Nakamura  1 , Yutaka Matsuhiro  1 , Koji Yasumoto  1 , Masaki Tsuda  1 , Naotaka Okamoto  1 , Akihiro Tanaka  1 , Yasuharu Matsunaga-Lee  1 , Masaki Yamato  1 , Ryu Shutta  1 , Masami Nishino  1 , Jun Tanouchi  1
Affiliations
Comparative Study

Comparison of myocardial injury and inflammation after pulmonary vein isolation for paroxysmal atrial fibrillation between radiofrequency catheter ablation and cryoballoon ablation

Masamichi Yano et al. J Cardiovasc Electrophysiol. 2020 Jun.

Abstract

Backgrounds: Several studies have shown the serum high sensitive cardiac troponin I (hs-TnI) a biomarker of myocardium injury, and C-reactive protein (CRP), a biomarker of inflammation, are associated with worse cardiovascular outcomes. We evaluated the relationship between the hs-TnI level in patients with paroxysmal atrial fibrillation (PAF) after pulmonary vein isolation (PVI) and atrial fibrillation (AF) recurrence.

Methods and results: We enrolled 263 consecutive PAF patients who underwent PVI from May 2017 to April 2018. We investigated the difference in the relationship between the myocardial injury marker (serum hs-TnI), inflammatory marker (CRP, white blood cell) at 36 to 48 hours after the PVI, and early or late recurrence of AF (ERAF; <3 months and LRAF; from 3 months to 1 year) between the radiofrequency ablation group (R group) and cryoballoon ablation group (C group). The R group consisted of 147 patients and the C groups consisted of 116 patients. The serum hs-TnI level in R group was significantly lower than in the C group (2.33 vs 5.08 ng/mL; P < .001), while the CRP was significantly higher in the R group than C group (2.02 vs 1.10 mg/dL; P < .001). The incidences of an ERAF/LRAF were similar between the two groups.

Conclusion: Cryoballoon ablation may cause more myocardial injury than radiofrequency catheter ablation, on the contrary, radiofrequency catheter ablation, may cause more inflammation than cryoballoon ablation. However, these phenomena may not affect the recurrence of AF after the PVI in patient with PAF.

Keywords: high-sensitive cardiac troponin-T; inflammation; myocardial injury; paroxysmal atrial fibrillation; pulmonary vein isolation; recurrence of AF.

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References

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