Assessment of the left atrial remodelling in patients with paroxysmal atrial fibrillation after cryoablation

Aim: Cryoballoon-based pulmonery vein isolation (PVI) is a treatment option for paroxysmal atrial fibrillation (PAF) in recent years. It is known that PVI remains sinus rhythm better than medical traetment in PAF patients. At the same time effects of PVI on atrial remodelling is not well understood. Left atrial volume (LAV) and left atrial volume index (LAVi) are the significant parameters for left atrial remodelling. Galectin-3 (Gal-3) and neutrophil to lymphocyte ratio (NLR) are important biomarkers to demonstrate the cardiac fibrosis, inflammation and cardiac remodelling. In this study, we aimed to investigate the relationship between LAV, LAVi, Gal-3 and NLR and AF reccurence. Materials and methos: 50 patients with symptomatic PAF despite 1 antiarrhythmic drug(s), who underwent cryoballoon-based pulmonery vein ablation were enrolled in our study. LAV, LAVi, Gal-3 and NLR were calculated before ablation and after ablation at 6 and 12 months. 7-day event recorder were performed to all patients before ablation and after ablation at 6 and 12 months in order to AF recurrence. Patients were divided into two groups, these are recurrent (n=14) and non-recurrent (n=36). LAV, LAVi, Gal-3 and NLR which evaluate to predict the recurrence, were compared between these two groups. Results: Both LAV nad LAVi were significant high in reccurent group. In recurrent group, before ablation LAV was 41.39±18.13 ml, after ablation at 12 months LAV was 53.24±22.11 ml (p=0.037). LAVi was 20.9±8.91 ml/m2before ablation and 26.85±11.28 ml/m2after ablation at 12 months. Both LAV nad LAVi were significant high in reccurent group. There was no significant difference in Gal-3. In recurrent group mean Gal-3 level was 6.34±4.13 ng/ml before the ablation and 6.66±4.09 ng/ml after ablation at 12 months (p=0.516). Similar to Gal-3, there was no significant difference in NLR. Before the ablation mean NLR was 3.15±1.59 103/µl and 2.28±1.07 103/µl after ablation at 12 months in recurrent group. Both Gal-3 and NLR were not significant in two groups, therefore Gal-3 and NLR are not predictable markers for AF recurrence after ablation. Conclusion: In this studyLAV and LAVi are useful to predict the remodelling of the left atrium and AF recurrence after cryoballoon-based pulmonery vein ablation. However, biomarkers such as Gal-3 and NLR, which demonstrates cardiac fibrosis, are not associated with AF recurrence. Key words: Paroxysmal atrial fibrillation, galectin-3, neutrophil to lymphocyte ratio, left atrial volume, left atrial volume index.