Impact Of Smoking On Long Term Atrial Fibrillation Ablation Success

Abstract

Aim: To investigate the recurrence rates after Atrial Fibrillation (AF) ablation therapy in smokers compared to nonsmokers.
 Material and Method: Patients who underwent Pulmonary Vein Isolation (PVI) ablation for symptomatic AF unresponsive to medical therapy between January 2016 and June 2018 were included in the study. Demographic data and smoking were obtained from medical records registered in the hospital database. For PVI, RF ablation with 3D mapping or Cryobalon ablation was performed according to operator preference. A 12-lead surface electrocardiogram and 24-hour ambulatory Holter electrocardiogram were performed at 1 and 3 months after the procedure and every 3 months thereafter. A 3-month blind period was used when evaluating AF recurrences. AF recurrence was defined as an episode lasting longer than 30 seconds. New onset atrial tachycardia and atrial flutter were also considered as recurrences.
 Results:139 patients who underwent AF ablation were included in our study. AF recurrence was observed in 38 (27.3%) of the patients included in the study during a total follow-up period of 37 months. Age, gender, hypertension and diabetes history were similar in both groups (all p values> 0.05). However, smokers were more common in the relapsed group (39.5% vs. 21.8%, p=0.03). Except for 0.3 mg/dl, p=0.04) values, no significant biochemical parameter affecting AF recurrence was detected. As a result of multivariate regression analysis, independent predictors of recurrence after AF ablation were smoking (OR=2.29, 95% CI 1-5.23, p=0.05) and Neutrophil/Lymphocyte Ratio (NLR) over 3 (OR=3.08, 95% CI 1.09). -8.69, p = 0.033).
 Conclusion: It was determined that recurrence after AF ablation treatment was higher in smokers compared to non-smokers. Smoking cessation therapy should be considered primarily in order to prevent recurrence in patients receiving AF ablation therapy.