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.
Key Words: atrial fibrillation; pulmonary vein isolation; inflammation; recurrence of atrial fibrillation after pulmonary vein isolation; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; left atrium-pulmonary vein reconnection.
INTRODUCTION
Atrial fibrillation (AF) is the most common arrhythmia. Pulmonary vein isolation (PVI) has become established as a standard therapy for patients with drug-refractory paroxysmal atrial fibrillation (PAF)1-3 since extra-systoles from pulmonary veins (PV) are the most common AF trigger activity.4 The efficacy and safety of the PVI of AF have been reported in several randomized trials.5-7 There are many studies that have evaluated the predictors of recurrences after PVI.8-10 The inflammatory response level after ablation was significantly associated with early recurrence of AF/atrial tachycardia (AT) (ERAF) within 3 days after the procedure.11-12 Several reports have shown that the incidence of an ERAF after PVI is approximately 40% and ERAFs are only a transient phenomenon attributed to the ablation related inflammatory process.13 On the contrary, there was a report that showed AF recurrence within 48 hours of a PVI was a predictor of a poor clinical outcome on follow-up.14The relationship between the inflammation level and hemogram parameters such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been proposed as reliable indicators of the immune activation and inflammation.15-16 Their measurements have proven to be useful prognostic biomarkers in cardiovascular disease.17 However, it is unclear whether the NLR and PLR are associated with ERAFs or late recurrences of AF (LRAFs). Therefore, in the present study, we aimed to investigate the relationship between the hemogram parameters (NLR and PLR) and ERAFs and LRAFs after the PVI. Secondly, we aimed to investigate the association between the hemogram parameters and electrophysiological findings in the repeat ablation sessions.
METHODS