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

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?=?14) and non-recurrent AF (n?=?36).

Results

In both groups (recurrent and non-recurrent), initial and 12 months follow-up LAV values were 41.39?±?18.13?ml and 53.24?±?22.11?ml vs 48.85?±?12.89?ml and 42.08?±?13.85 (p?=?0.037). LAVi were 20.9?±?8.91 ml/m2 and 26.85?±?11.28 ml/m2 vs 25.36?±?6.21 and 21.87?±?6.66 (p?=?0.05) 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?±?4.09?ng/ml and 6.02?±?2.95?ng/ml (p?=?0.516), N/L ratio values of 2.28?±?1.07 10³/μl and 1.98?±?0.66?10³/μl (p?=?0.674).

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.