Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
PLoS One. 2019 Jul 2;14(7):e0219269. doi: 10.1371/journal.pone.0219269. eCollection 2019.
One of the mechanisms of early recurrence of atrial fibrillation (ERAF) after AF ablation is considered to be the inflammatory reaction of the atrial tissue. The aim of this study is to compare the clinical significance of ERAF at each stage for true AF recurrence between cryoballoon (CB) and radiofrequency (RF) ablation.
Among 798 paroxysmal AF patients who underwent an initial ablation, 460 patients (CB, n = 230; RF, n = 230) were selected by propensity score matching. Very ERAF (VERAF), ERAF-1M, ERAF-3M and true AF recurrence were defined as AF recurrence at 0-2, 3-30, 31-90 days and more than 90 days after the procedure, respectively.
The patient characteristics of the two groups were similar. ERAF was observed 21% and 27% in the CB and RF groups, respectively. In both the CB and RF group, VERAF, ERAF-1M and ERAF-3M were more frequently observed in patients with true AF recurrence than in those without. In a multivariable analysis, ERAF-1M and ERAF-3M were found to be independent predictors of true AF recurrence in both the CB (P = 0.04 and P<0.001, respectively) and RF groups (P = 0.02 and P = 0.001, respectively). However, while VERAF was associated with true AF recurrence after RF ablation (P = 0.03), it was not associated with true AF recurrence after CB ablation (P = 0.19).
The relationship between ERAF and true AF recurrence differed between the RF and CB ablation groups. While VERAF was associated with true AF recurrence after RF ablation, it was not a predictor of true AF recurrence after CB ablation.
房颤消融后早期复发（ERAF）的机制之一被认为是心房组织的炎症反应。本研究旨在比较冷冻球囊（CB）和射频（RF）消融中各阶段 ERFA 对真正房颤复发的临床意义。
在 798 例阵发性房颤患者中，进行了首次消融，通过倾向评分匹配，选择了 460 例患者（CB，n=230；RF，n=230）。非常 ERFA（VERAF）、ERAF-1M、ERAF-3M 和真正的房颤复发分别定义为术后 0-2、3-30、31-90 天和 90 天以上的房颤复发。
两组患者的特征相似。CB 组和 RF 组的 ERFA 分别为 21%和 27%。在 CB 和 RF 两组中，真正的房颤复发患者比无复发患者更常出现 VERAF、ERAF-1M 和 ERFA-3M。多变量分析显示，ERAF-1M 和 ERFA-3M 是 CB（P=0.04 和 P<0.001）和 RF 组（P=0.02 和 P=0.001）中真正的房颤复发的独立预测因素。然而，虽然 VERAF 与 RF 消融后真正的房颤复发相关（P=0.03），但与 CB 消融后真正的房颤复发无关（P=0.19）。
ERAF 与 RF 和 CB 消融后真正的房颤复发之间的关系不同。虽然 VERAF 与 RF 消融后真正的房颤复发相关，但不是 CB 消融后真正的房颤复发的预测因素。
