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Inflammation markers, neutrophil-to-lymphocyte ratio and platelet-to lymphocyte ratio after pulmonary vein isolation, were associated with late clinical outcomes and pulmonary vein reconnections
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  • Masamichi Yano,
  • Yasuyuki Egami,
  • Kohei Ukita,
  • Akito Kawamura,
  • Hitoshi Nakamura,
  • Yutaka Matsuhiro,
  • Koji Yasumoto,
  • Masaki Tsuda,
  • Naotaka Okamoto,
  • Akihiro Tanaka,
  • Yasuharu Matsunaga-Lee,
  • Ryu Shutta,
  • Masami Nishino,
  • Jun Tanouchi
Masamichi Yano
Osaka Rosai Hospital
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Yasuyuki Egami
Osaka Rosai Hospital
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Kohei Ukita
Osaka Rosai Hospital
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Akito Kawamura
Osaka Rosai Hospital
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Hitoshi Nakamura
Osaka Rosai Hospital
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Yutaka Matsuhiro
Osaka Rosai Hospital
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Koji Yasumoto
Osaka Rosai Hospital
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Masaki Tsuda
Osaka Rosai Hospital
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Naotaka Okamoto
Osaka Rosai Hospital
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Akihiro Tanaka
Osaka Rosai Hospital
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Yasuharu Matsunaga-Lee
Osaka Rosai Hospital
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Ryu Shutta
Osaka Rosai Hospital
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Masami Nishino
Osaka Rosai Hospital
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Jun Tanouchi
Osaka Rosai Hospital
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Abstract

Background Previous reports demonstrated that the early recurrence of atrial fibrillation (ERAF) after pulmonary vein isolation (PVI) was associated with the inflammatory process. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been proposed as indicators of a systemic inflammatory response. However the relationship between NLR/PLR and clinical outcomes after PVI remains unclear. Methods and Results We enrolled 633 consecutive atrial fibrillation (AF) patients who underwent PVI from September 2014 to June 2018. The NLR and PLR in peripheral blood leukocytes 1 day before and 36-48 hours after PVI were measured. We compared the NLR and PLR changes in each parameter (ΔNLR and ΔPLR) between a late recurrence of AF group after the PVI (LRAF, during 1 year after PVI) and the no-LRAF group. We also evaluated the relationship between the ΔNLR /ΔPLR and pulmonary vein (PV) reconnections in repeated ablation procedures. The LRAF patients consisted of 151 patients (23.9%). The ΔNLR and ΔPLR were significantly higher in the LRAF group than no-LRAF group (p=0.021, p=0.011). The ΔNLR in the initial ablation sessions was significantly higher in patients with right PVs reconnections than in those without in the repeat ablation sessions (0.914±1.199 vs 2.316±3.615, p=0.032). Conclusion The NLR and PLR changes were associated with an LRAF. A higher NLR change in the initial ablation session was associated with a right PV reconnection in the repeat ablation session.