Comparison of myocardial injury and inflammation after pulmonary vein isolation for paroxysmal atrial fibrillation between radiofrequency catheter ablation and cryoballoon ablation

Yano, Masamichi; Egami, Yasuyuki; Yanagawa, Kyosuke; Nakamura, Hitoshi; Matsuhiro, Yutaka; Yasumoto, Koji; Tsuda, Masaki; Okamoto, Naotaka; Tanaka, Akihiro; Matsunaga‐Lee, Yasuharu; Yamato, Masaki; Shutta, Ryu; Nishino, Masami; Tanouchi, Jun

doi:10.1111/jce.14475

Cited by 42 publications

(51 citation statements)

References 20 publications

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“…They speculated that the freeze and thaw process with cardiomyocyte swelling and membrane rupture might produce a greater elevation of myocardial injury markers but maintained the endothelial structure. However, radiofrequency energy could induce a relapse of endothelial inflammatory cytokines 16 . We had previously reported the feasibility of imaging inflammation after both CBA and radiofrequency hot balloon ablation (RHA) as a case report, in which the FDG uptake was likely greater after RHA than after CBA 6 .…”

Section: Discussionmentioning

confidence: 99%

“…However, radiofrequency energy could induce a relapse of endothelial inflammatory cytokines. 16 We had previously reported the feasibility of imaging inflammation after both CBA and radiofrequency hot balloon ablation (RHA) as a case report, in which the FDG uptake was likely greater after RHA than after CBA. 6 In this study, the CRP as well as creatine kinase (CK) and…”

Section: Main Findingsmentioning

confidence: 99%

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Visualization of intensive atrial inflammation and fibrosis after cryoballoon ablation: PET/MRI and LGE‐MRI analysis

Kiuchi

Fukuzawa

Nogami

et al. 2020

Journal of Arrhythmia

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Background: Atrial inflammation plays an important role in initiating atrial fibrosis, which could perpetuate atrial fibrillation (AF). However, the method of visualization of atrial inflammation has not been established. We sought to investigate whether the intensive atrial inflammation caused by cryoballoon ablation (CBA) could be detected by positron emission tomography/ magnetic resonance imaging (PET/MRI) and whether the atrial inflammation could be associated with consequent fibrosis. Methods: A total of 10 paroxysmal atrial fibrillation patients after CBA were enrolled. To detect and quantify intensive atrial inflammation, PET/MRI was performed to assess regional 18 F-fluorodeoxyglucose (18 F-FDG) uptake one day after the CBA, and the standardized uptake values (SUV) max were compared between the pulmonary vein (PV) antrum where CBA could be applied and the healthy left atrial (LA) wall where CBA could not be applied. Furthermore, the atrial inflammation one day after the procedure and atrial fibrosis areas one month after the procedure were threedimensionally quantified by PET/MRI and late-gadolinium enhancement magnetic resonance imaging (LGE-MRI), respectively. Results: The mean SUV max at the PV antrum was significantly higher than that on the healthy LA wall (2.12 ± 0.35 vs 1.73 ± 0.30, P = .00021). The volume of the atrial inflammation strongly correlated with that of the atrial fibrosis (r = .94 [.76-.99], P = .00006). Conclusions: The atrial inflammation after CBA could be detected by PET/MRI. CBA-induced atrial inflammation was strongly associated with consequent lesion maturation.

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Section: Discussionmentioning

confidence: 99%

Section: Main Findingsmentioning

confidence: 99%

Visualization of intensive atrial inflammation and fibrosis after cryoballoon ablation: PET/MRI and LGE‐MRI analysis

Kiuchi

Fukuzawa

Nogami

et al. 2020

Journal of Arrhythmia

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“…Consecutive AF patients who underwent a PVI by radiofrequency catheter ablation were enrolled from September 2014 to June 2018 in our hospital. The patients who underwent a PVI by cryoballoon ablation were excluded because of the different mechanism of myocardial injury and inflammation between radiofrequency catheter ablation and cryoballoon ablation [20] . In the present study, PAF was defined as AF persistence for within 1 week and PerAF was defined as AF persistence for more than 1 week.…”

Section: Methodsmentioning

confidence: 99%

Atrial fibrillation type modulates the clinical predictive value of neutrophil-to-lymphocyte ratio for atrial fibrillation recurrence after catheter ablation

Yano

Egami

Ukita

et al. 2020

IJC Heart & Vasculature

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Background The neutrophil-to-lymphocyte ratio (NLR) has been proposed as an indicator of a systemic inflammatory response. There are baseline differences in the inflammation status between paroxysmal atrial fibrillation (PAF) and persistent AF (PerAF). The NLR changes and late recurrences of AF (LRAF) after ablation depending on the AF type remain unknown. Methods Consecutive AF patients undergoing pulmonary vein isolation (PVI) by radiofrequency catheter ablation were enrolled from September 2014 to June 2018. The peripheral blood leukocyte NLR 1 day before and 36–48 h after PVI were measured. First, the relationship between NLR changes after to before ablation (ΔNLR) and ERAFs/LRAFs in PAF and PerAF patients were investigated to exclude the baseline inflammation status and evaluate catheter ablation induced inflammation. Second, the clinical impact of the NLR for predicting LRAFs was evaluated. Results There hundred sixty-nine PAF and 264 PerAF patients from Osaka Rosai AF registry were enrolled. The ratio of ERAFs/LRAFs in PAF and PerAF patients were 26.8%/22.5% and 39.4%/29.9%, respectively. In PAF and PerAF patients, the ΔNLR was significantly higher with ERAF than no-ERAF (p = 0.022 and p = 0.010, respectively). In PAF patients, the ΔNLR was significantly higher with LRAF than no-LRAF (p = 0.017), while with PerAF, the ΔNLR did not significantly differ between LRAFs and no-LRAFs. In PAF, the ΔNLR was independently and significantly associated with LRAFs after PVI (p = 0.029). Conclusion The ΔNLR was significantly higher only in PAF patients with LRAFs than no-LRAFs, but not in PerAF patients. The ΔNLR was useful for predicting LRAFs after PVI in PAF patients.

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“…Hence, their isolation via catheter ablation is nowadays the cornerstone for the treatment of symptomatic paroxysmal AF [3]. For that purpose, a common procedure is radiofrequency ablation, which consists of applying current around PV in a pointby-point fashion to provoke permanent lesions by heating [4]. Nonetheless, cryoablation has recently received extensive attention, since it can be applied in a less complex and faster way, and moreover is able to obtain similar mid-and long-term success rates [5].…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, cryoablation has recently received extensive attention, since it can be applied in a less complex and faster way, and moreover is able to obtain similar mid-and long-term success rates [5]. In this case, a balloon is used to apply cryogenic energy around each PV in a single-step, thus causing atrial lesions by freezing [4].…”

Section: Introductionmentioning

confidence: 99%

Predicting Atrial Fibrillation Recurrence After Catheter Ablation Through Time Variability of P-wave Features

Ruiz¹,

Arias²,

Puchol³

et al. 2020

2020 Computing in Cardiology Conference (CinC)

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Nowadays, the first-line therapy for paroxysmal atrial fibrillation (PAF) is pulmonary vein isolation through catheter ablation. However, the success rate of this procedure is still not as high as desirable. Thus, preoperative prediction of early AF recurrence after ablation is a challenge to select optimal candidates for the intervention. To this end, some promising predictors based on the P-wave in short ECG signals have been proposed in the last years. However, evolution of the P-wave along the time has still not been analyzed. Hence, the present work studies how time variability of two features of the P-wave predicts midterm cryoablation failure. For 45 PAF patients, a standard 12-lead ECG signal was obtained for 5 minutes before ablation. An automatic algorithm was then used to delineate all P-waves in lead II, and duration and amplitude were computed. The resulting time series were characterized by their mean, standard deviation and coefficient of variation (CV). Correlating these measures with ablation outcome, the CV for both parameters obtained the best discrimination between patients. In fact, compared with the mean value, the CV for both features obtained accuracies 10% greater, thus achieving values of 70%. These outcomes entail that time variability of the P-wave can reveal new information about the proarrhythmic condition of the patients, thus improving predictions of ablation failure.

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Comparison of myocardial injury and inflammation after pulmonary vein isolation for paroxysmal atrial fibrillation between radiofrequency catheter ablation and cryoballoon ablation

Cited by 42 publications

References 20 publications

Visualization of intensive atrial inflammation and fibrosis after cryoballoon ablation: PET/MRI and LGE‐MRI analysis

Visualization of intensive atrial inflammation and fibrosis after cryoballoon ablation: PET/MRI and LGE‐MRI analysis

Atrial fibrillation type modulates the clinical predictive value of neutrophil-to-lymphocyte ratio for atrial fibrillation recurrence after catheter ablation

Predicting Atrial Fibrillation Recurrence After Catheter Ablation Through Time Variability of P-wave Features

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