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. 2022 Sep 7;22(1):400.
doi: 10.1186/s12872-022-02816-1.

Early recurrence after cryoballoon versus radiofrequency ablation for paroxysmal atrial fibrillation: mechanism and implication in long-term outcome

Yue Wei #  1 , Yangyang Bao #  1 , Changjian Lin  1 , Yun Xie  1 , Qingzhi Luo  1 , Ning Zhang  2 , Liqun Wu  3
Affiliations

Early recurrence after cryoballoon versus radiofrequency ablation for paroxysmal atrial fibrillation: mechanism and implication in long-term outcome

Yue Wei et al. BMC Cardiovasc Disord. .

Abstract

Background: Early recurrence (ER) after catheter ablation for atrial fibrillation (AF) has been considered as a common phenomenon but its mechanism and implication in long-term outcome has not been fully elucidated. We aimed to clarify the relation between post-ablation inflammation and ER after cryoballoon ablation (CBA) or radio-frequency ablation (RFA) and evaluate the clinical significance of ER.

Methods: A total of 154 patients with paroxysmal AF undergoing ablation were consecutively recruited, including 90 patients undergoing RFA (RF group) and 64 patients undergoing CBA (CB group). Myocardial injury and inflammation biomarkers were analyzed before and 6 h, 24 h and 48 h after ablation. Acute early recurrence (AER), non-acute early recurrence (NAER) and late recurrence (LR) was defined as recurrence of atrial tachyarrhythmia during 0-3, 4-90 days and beyond a 90-day blanking period after ablation.

Results: Cardiac troponin I was significantly higher in CB group while C reactive protein (CRP) and Ratio Neutrophil/Lymphocyte were more elevated in RF group. Higher CRP level after RFA was significantly associated with AER in RF group and lower CRP level after CBA was predictive of AER in CB group. In addition, average cryoablation duration was positively correlated with CRP level after CB group. Cox regression revealed that NAER and left atrial diameter were associated with LR in RF group, while AER and NAER were predictive of LR after CBA.

Conclusions: Post-ablation inflammation was greater in RFA than in CBA. Excessive inflammatory response may be an important factor of AER after RFA. AER after CBA was related with lower inflammation and predictive of LR. Further investigations are still warranted to address on these findings.

Keywords: Atrial fibrillation; Cryoballoon ablation; Early recurrence; Inflammation; Radio-frequency ablation.

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Conflict of interest statement

The authors have no competing interest to declare.

Figures

Fig. 1
Fig. 1
Kinetics of cTnI in CBA and RFA group with and without ER. ***: CB vs. RF, P<0.001
Fig. 2
Fig. 2
Kinetics of CRP in CBA and RFA group with and without ER. ***: CB vs. RF, P<0.001; #: RF with ER vs RF without ER, P<0.05
Fig. 3
Fig. 3
Kinetics of N/L in CBA and RFA group with and without ER. *: CB vs. RF, P<0.05
Fig. 4
Fig. 4
Level of CRP24h in CBA and RFA group with AER, with NAER and without ER. **: RF with AER vs. RF with NAER or RF without ER, P<0.01
Fig. 5
Fig. 5
Level of CRP48h in CBA and RFA group with AER, with NAER and without ER. *: RF with AER vs. RF with NAER, P<0.05; **: RF with AER vs. RF without ER, P<0.01; #: CB with AER vs. CB without ER, P<0.05
Fig. 6
Fig. 6
Scatter plot and regression line of CRP48h and average cryoduration
Fig. 7
Fig. 7
Kaplan–Meier Survival Curve in CBA and RFA group with and without ER. Log-Rank P<0.001
See this image and copyright information in PMC

References

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