Abstract
Inflammation, oxidative stress, myocardial injury biomarkers and clinical parameters (longer AF duration, left atrial enlargement, the metabolic syndrome) are factors commonly related to AF recurrence. This study aims to assess the predictive value of laboratory and clinical parameters responsible for early recurrence of atrial fibrillation (ERAF) following cryoballoon ablation (CBA) using statistical assessment and machine learning algorithms. This study group comprised 118 consecutive patients (mean age, 62.5 ± 7.8 years; women 36%) with paroxysmal (54.1%) and persistent (45.9%) AF who underwent their first pulmonary vein isolation (PVI) performed by CBA (Arctic Front Advance 2nd generation 28 mm). The biomarker concentrations were measured at baseline and after CBA in a 24-h follow-up. ERAF was defined as at least a 30-s episode of arrhythmia registered by a 24 h-Holter monitor within the 3 months following the procedure. 56 clinical, laboratory and procedural variables were collected from each patient. We used two classification algorithms: support vector machines, gradient boosted tree. The synthetic minority over-sampling technique (SMOTE) was used to provide a balanced training data set. Within a period of 3 months 21 patients (17.8%) experienced ERAF. The statistical analysis indicated that the lowered levels of post-ablation TnT (p = 0.043) and CK-MB (p = 0.010) with the TnT elevation (p = 0.044) were the predictors of ERAF following CBA. In addition, diabetes and statin treatment were significantly associated with ERAF after CBA (p < 0.05). The machine learning algorithms confirmed the results obtained in the univariate analysis.
Highlights
Cryoballoon ablation (CBA) of pulmonary veins, along with radiofrequency ablation (RFCA), is a widely acknowledged method of atrial fibrillation (AF) treatment
We decided to focus on the clinical significance of early recurrence of atrial fibrillation (ERAF) given that many published studies consider it one of the most frequent factors contributing to the failure of the procedure in the long run
The study consisted of 118 consecutive patients with paroxysmal and permanent AF who were referred to the department of cardiology in Nowa Sól, Poland from May 2016 till September 2017 to undergo their first pulmonary vein isolation (PVI) performed through CBA (Arctic Front Advance 2nd generation 28 mm) in accordance with international guidelines
Summary
Cryoballoon ablation (CBA) of pulmonary veins, along with radiofrequency ablation (RFCA), is a widely acknowledged method of atrial fibrillation (AF) treatment. Pulmonary vein isolation (PVI) is a crucial element of the AF ablation procedure [1]. It has been estimated that nearly half of patients experience early arrhythmia recurrence in a 3-month followup [2,3,4]. Such conclusions have been drawn in a substudy of a multicenter randomized STOP AF trial where above half (51.5%) of the patients who had undergone CBA suffered from ERAF after the index-PVI procedure. 55.6% of patients with ERAF experienced LRAF (p < 0.001)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
