Abstract:Objective To investigate the correlation between the recurrence of atrial fibrillation (AF) after secondgeneration cryoballoon ablation (CBA), and perioperative atrial tachyarrhythmia (AT) and cardiac troponin I (cTnI). Methods Forty-five AF patients undergoing CBA were enrolled, and divided into recurrence group and nonrecurrence group according to the presence or absence of AT after the ablation blanking period (3 months). Clinical data, laboratory examination results, surgical parameters, complications and follow-up data of the two groups were comparatively analyzed. Results (ⅰ) At a mean follow-up period of (14.3±3.7) months after ablation, sinus rhythm still maintains in 31 patients of the non-recurrence group while AF recurs in 14 patients of the recurrence group, with a success rate of 68.9%. Perioperative AT occurs in 5 cases (16.1%) of the non-recurrence group and 10 (71.4%) cases of the recurrence group, respectively, with statistically significant difference(P<0.01). However, binary Logistic regression analysis shows no significant correlation between perioperative AT and AF recurrence after ablation (OR=595, P>0.05). (ⅱ) The cTnI level 6 hours after operation in the recurrence group is lower than that in the non-recurrence group[(7.4±1.9) ng/mL vs. (11.8±3.1)ng/mL, P<0.01]. Regression analysis suggests a correlation between cTnI level 6 hours after ablation and postoperative AF recurrence (OR=0.56, P=0.034). (ⅲ) Subgroup analysis reveals that among 12 patients with persistent AF and 33 patients with paroxysmal AF, AF separately recurs in 5 (41.7%) and 9 (27.3%) cases after CBA, without statistically significant difference (P>0.05). Conclusion CBA is safe and effective in treating both paroxysmal and persistent AF. Monitoring for postoperative cTnI level helps to rapidly predict the recurrence of AF after CBA, and provide clinical references for a secondary ablation.
储锐锐,王岳松,董学滨,邵旭武,王学忠. 房颤冷冻球囊消融术后复发与围手术期房性快速性心律失常及心肌肌钙蛋白的关系[J]. 实用心电学杂志, 2022, 31(6): 416-421.
CHU Ruirui, WANG Yuesong, DONG Xuebin, SHAO Xuwu, WANG Xuezhong. Correlation between recurrence of atrial fibrillation after cryoballoon ablation, and perioperative atrial tachyarrhythmia and cardiac troponin. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2022, 31(6): 416-421.