Inflammatory Response after Different Ablation Strategies for Paroxysmal Atrial Fibrillation

Authors

  • Guangli Yin Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
  • Bofei Ma Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
  • Bolun Zhou Xiangya School of Medicine, Central South University, Changsha, China
  • Jinglan Wu Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
  • Ling You Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
  • Ruiqin Xie Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China

DOI:

https://doi.org/10.1532/hsf.3149

Keywords:

paroxysmal atrial fibrillation; catheter ablation; inflammation; recurrence of atrial fibrillation

Abstract

Background: Catheter ablation for atrial fibrillation (AF) has been gaining popularity; however, the trend of inflammatory response markers in patients treated with different catheter ablation strategies over time and their predictability of AF recurrence remain unknown.

Methods: A total of 210 patients with AF were enrolled and grouped according to surgical mode as follows: freeze group, RF group, and freeze3D group. The subjects were tested for related indexes before and after surgery. To determine AF recurrence during follow up, 24-h ambulatory electrocardiography was performed at two, three, six, and 12 months after surgery.

Results: The inflammation indexes of the three groups peaked between one and three days after surgery but fell at different time points (P < .05). The recurrence rate of paroxysmal atrial fibrillation (PAF) was positively correlated with the increase in the percentage of white blood cells and neutrophils after surgery (P < .05).

Conclusions: The postoperative inflammation indices peaked and fell at different time points after different catheter ablation methods. In addition, the recurrence rate of AF in patients treated with freeze3D is lower.

References

Afari N, Mostoufi S, Noonan C, et al. 2011. C-Reactive Protein and Pain Sensitivity: Findings from Female Twins. Ann Behav Med 42:277-283.

An K, Zhu J, Ma N, Tang M, Mei J. 2018. Predictive risk factors for recurrent atrial fibrillation after modified endoscopic ablation: A 2-year follow-up. Clin Cardiol 41:372-377.

Antolič B, Pernat A, Cvijić M, Žižek D, Jan M, Šinkovec M. 2016. Radiofrequency catheter ablation versus balloon cryoablation of atrial fibrillation: markers of myocardial damage, inflammation, and thrombogenesis. Wien Klin Wochenschr 128:480-487.

Bruins P, te Velthuis H, Yazdanbakhsh AP, et al. 1997. Activation of the complement system during and after cardiopulmonary bypass surgery: postsurgery activation involves C-reactive protein and is associated with postoperative arrhythmia. Circulation 96:3542-3548.

Chierchia GB, de Asmundis C, Müller-Burri SA, et al. 2009. Early recovery of pulmonary vein conduction after cryoballoon ablation for paroxysmal atrial fibrillation: a prospective study. Europace 11:445-449.

da Silva RM. 2017. Influence of inflammation and atherosclerosis in atrial fibrillation. Curr Atheroscler Rep 19:2.

Deneke T, Khargi K, Müller KM, et al. 2005. Histopathology of intraoperatively induced linear radiofrequency ablation lesions in patients with chronic atrial fibrillation. Eur Heart J 26:1797-1803.

Gerstenfeld EP, Callans DJ, Dixit S, Zado E, Marchlinski FE. 2003. Incidence and location of focal atrial fibrillation triggers in patients undergoing repeat pulmonary vein isolation: implications for ablation strategies. J Cardiovasc Electrophysiol 14:685-690.

Jin LL, You L, Xie RQ. 2018. Value of cystatin C in predicting atrial fibrillation recurrence after radiofrequency catheter ablation. J Geriatr Cardiol 15:725-731.

Korantzopoulos P, Kolettis TM, Kountouris E, Siogas K, Goudevenos JA. 2005. Variation of inflammatory indexes after electrical cardioversion of persistent atrial fibrillation. Is there an association with early recurrence rates? Int J Clin Pract 59:881-885.

Krijthe BP, Kunst A, Benjamin EJ, et al. 2013. Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. Eur Heart J 34:2746-2751.

Kuck KH, Fürnkranz A, Chun KR, et al. 2016. Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation: reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial. Eur Heart J 37:2858-2865.

Lim HS, Schultz C, Dang J, et al. 2014. Time Course of Inflammation, Myocardial Injury, and Prothrombotic Response After Radiofrequency Catheter Ablation for Atrial Fibrillation. Circ Arrhythm Electrophysiol 7:83-89.

Mesas CE, Augello G, Lang CC, et al. 2006. Electroanatomic remodeling of the left atrium in patients undergoing repeat pulmonary vein ablation: mechanistic insights and implications for ablation. J Cardiovase Electrophysiol 17:1279-1285.

Mukherjee R. 2016. Fire in the "hall"! Myocardial inflammation and recurrence of atrial fibrillation. J Thorac Cardiovasc Surg 151:1683-1685.

Nanthakumar K, Plumb VJ, Epstein AE, Veenhuyzen GD, Link D, Kay GN. 2004. Resumption of electrical conduction in previously isolated pulmonary veins: rationale for a different strategy? Circulation 109:1226-1229.

Richter B, Gwechenberger M, Socas A, et al. 2012. Markers of oxidative stress after ablation of atrial fibrillation are associated with inflammation, delivered radiofrequency energy and early recurrence of atrial fibrillation. Clin Res Cardiol 101:217-225.

Rienstra M, Sun JX, Magnani JW, et al. 2012. White blood cell count and risk of incident atrial fibrillation (from the Framingham Heart Study). Am J Cardiol 109:533-537.

Schmidt M, Marschang H, Clifford S, et al. 2012. Trends in inflammatory biomarkers during atrial fibrillation ablation across different catheter ablation strategies. Int J Cardiol 158:33-38.

Shao M, Shang L, Shi J, et al. 2018. The safety and efficacy of second-generation cryoballoon ablation plus catheter ablation for persistent atrial fibrillation: A systematic review and meta-analysis. PLoS One 13:e0206362.

Stein A, Wessling G, Deisenhofer I, et al. 2008. Systemic inflammatory changes after pulmonary vein radiofrequency ablation do not alter stem cell mobilization. Europace 10:444-449.

Tselentakis EV, Woodford E, Chandy J, Gaudette GR, Saltman AE. 2006. Inflammation effects on the electrical properties of atrial tissue and inducibility of postoperative atrial fibrillation. J Surg Res 135:68-75.

Tzeis S, Pastromas S, Sikiotis A, Andrikopoulos G. 2016. Cryoablation in persistent atrial fibrillation – a critical appraisal. Neth Heart J 24:498-507.

Weymann A, Ali-Hasan-Al-Saegh S, Sabashnikov A, et al. 2017. Prediction of new-onset and recurrent atrial fibrillation by complete blood count tests: a comprehensive systematic review with meta-analysis. Med Sci Monit Basic Res 23:179-222.

Wolf PA, D'Agostino RB, Belanger AJ, Kannel WB. 1991. Probability of stroke: a risk profile from the Framingham study. Stroke 22:312-318.

Published

2020-09-29

How to Cite

Yin, G. ., Ma, B. ., Zhou, B. ., Wu, J. ., You, L. ., & Xie, R. (2020). Inflammatory Response after Different Ablation Strategies for Paroxysmal Atrial Fibrillation. The Heart Surgery Forum, 23(5), E703-E711. https://doi.org/10.1532/hsf.3149

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