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