Inflammation markers, neutrophil-to-lymphocyte ratio and platelet-to
lymphocyte ratio after pulmonary vein isolation, were associated with
late clinical outcomes and pulmonary vein reconnections
Abstract
Background Previous reports demonstrated that the early recurrence of
atrial fibrillation (ERAF) after pulmonary vein isolation (PVI) was
associated with the inflammatory process. The neutrophil to lymphocyte
ratio (NLR) and platelet to lymphocyte ratio (PLR) have been proposed as
indicators of a systemic inflammatory response. However the relationship
between NLR/PLR and clinical outcomes after PVI remains unclear. Methods
and Results We enrolled 633 consecutive atrial fibrillation (AF)
patients who underwent PVI from September 2014 to June 2018. The NLR and
PLR in peripheral blood leukocytes 1 day before and 36-48 hours after
PVI were measured. We compared the NLR and PLR changes in each parameter
(ΔNLR and ΔPLR) between a late recurrence of AF group after the PVI
(LRAF, during 1 year after PVI) and the no-LRAF group. We also evaluated
the relationship between the ΔNLR /ΔPLR and pulmonary vein (PV)
reconnections in repeated ablation procedures. The LRAF patients
consisted of 151 patients (23.9%). The ΔNLR and ΔPLR were significantly
higher in the LRAF group than no-LRAF group (p=0.021, p=0.011). The ΔNLR
in the initial ablation sessions was significantly higher in patients
with right PVs reconnections than in those without in the repeat
ablation sessions (0.914±1.199 vs 2.316±3.615, p=0.032). Conclusion The
NLR and PLR changes were associated with an LRAF. A higher NLR change in
the initial ablation session was associated with a right PV reconnection
in the repeat ablation session.