Gurses Kadri Murat, Yalcin Muhammed Ulvi, Kocyigit Duygu, Evranos Banu, Ates Ahmet Hakan, Yorgun Hikmet, Sahiner Mehmet Levent, Kaya Ergun Baris, Ozer Necla, Oto Mehmet Ali, Aytemir Kudret
Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
J Interv Card Electrophysiol. 2015 Jan;42(1):51-8. doi: 10.1007/s10840-014-9959-y. Epub 2014 Dec 16.
Elevated red blood cell distribution width (RDW) has been associated with atrial fibrillation (AF) in cross-sectional and prospective studies. In this study, we aim to evaluate the relation of preablation RDW levels to late AF recurrence following cryoablation.
A total of 299 patients with symptomatic paroxysmal or persistent AF despite ≥ 1 antiarrhythmic drug(s) who were scheduled for cryoballoon-based AF ablation were enrolled in this prospective study.
A total of 299 patients (55.40 ± 10.60 years, 49.20 % male) were involved and followed up at a median time of 24 (6-44) months. Patients with late AF recurrence had higher RDW levels (14.30 ± 0.93 vs. 13.52 ± 0.93 %, p < 0.001). Multivariate Cox proportional hazard regression analysis showed that RDW level was an independent predictor for late AF recurrence (HR 1.88, 95 % CI 1.41-2.50, p < 0.001) along with left atrial (LA) diameter (HR 3.09, 95 % CI 1.81-5.27, p < 0.001), duration of AF (HR 1.04, 95 % CI 1.01-1.07, p = 0.02), and early AF recurrence (HR 6.39, 95 % CI 3.41-11.97, p < 0.001). A cut-off level of 13.75 % for RDW predicted late AF recurrence following cryoballoon-based pulmonary vein isolation (PVI) with a sensitivity and specificity of 78.00 and 70.00 %, respectively.
These findings suggest that elevated RDW may be a predictor of late recurrence following cryoballoon-based AF ablation. Further studies are needed to establish its exact pathophysiologic and prognostic roles.
在横断面研究和前瞻性研究中，红细胞分布宽度（RDW）升高与心房颤动（AF）相关。在本研究中，我们旨在评估冷冻消融术前RDW水平与AF冷冻消融术后晚期复发的关系。
本前瞻性研究纳入了299例尽管使用了≥1种抗心律失常药物仍有症状性阵发性或持续性AF且计划进行基于冷冻球囊的AF消融的患者。
共纳入299例患者（年龄55.40±10.60岁，男性占49.20%），中位随访时间为24（6 - 44）个月。AF晚期复发患者的RDW水平更高（14.30±0.93 vs. 13.52±0.93%，p<0.001）。多变量Cox比例风险回归分析显示，RDW水平是AF晚期复发的独立预测因素（风险比1.88，95%置信区间1.41 - 2.50，p<0.001），此外还有左心房（LA）直径（风险比3.09，95%置信区间1.81 - 5.27，p<0.001）、AF持续时间（风险比1.04，95%置信区间1.01 - 1.07，p = 0.02）和AF早期复发（风险比6.39，95%置信区间3.41 - 11.97，p<0.001）。RDW的截断水平为13.75%时，预测基于冷冻球囊的肺静脉隔离（PVI）术后AF晚期复发的敏感性和特异性分别为78.00%和70.00%。
这些发现表明，RDW升高可能是基于冷冻球囊的AF消融术后晚期复发的预测因素。需要进一步研究以确定其确切的病理生理和预后作用。
