Impact Of Smoking On Long Term Atrial Fibrillation Ablation Success

Yıl 2022, Cilt: 6 Sayı: 1, 268 - 276, 27.01.2022

Esra Duğral Oguzhan Ekrem Turan Ahmet Anıl Başkurt Emin Evren Özcan

https://doi.org/10.30621/jbachs.1003047

Öz

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.

Anahtar Kelimeler

Smoking, Atrial Fibrillation, Ablation Therapy, Recurrens, Inflamation

Kaynakça

• 1. Heeringa J, van der Kuip DAM, Hofman A, Kors JA, van Herpen G, Stricker BHC, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J 2006; 27:949–53
• 2. Chugh, S. S., Havmoeller, R., Narayanan, K., Singh, D., Rienstra, M., Benjamin, E. J., Gillum, R. F., Kim, Y., McAnulty, J. H., Zheng, Z., Forouzanfar, M. H., Naghavi, M., Mensah, G. A., Ezzati, M., & Murray, C. J. L. (2014). Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation, 129, 837–847
• 3. AHA/ACC/HRS Guideline fort he Management of Patients With Atriyal Fibrillation, A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Hearth Rhythm Society 2014
• 4. Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, et al. Management of patients with atrial fibrillation (Compilation of 2006 ACCF/AHA/ESC and 2011 ACCF/AHA/HRS Recommendations). Journal of the American College of Cardiology. 2013; 61(18):1935-44)
• 5. Gronefeld GC, Lilienthal J, Kuck KH, Hohnloser SH; Pharmacological Intervention in Atrial Fibrillation (PIAF) Study Investigators. Impact of rate versus rhythm control on quality of life in patients with persistent atrial fibrillation: results from a prospective randomized study. Eur Heart J 2003; 24:1430–1436
• 6. Goette A, Lendeckel U, Kuchenbecker A, Bukowska A, Peters B, Klein HU, etal. Cigarette smoking induces atrial fibrosis in humans via nicotine. Heart 2007;93(9): 1056–63
• 7. Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and Cardiovascular disease: anupdate. Journal of the American College of Cardiology 2004;43(10): 1731–7
• 8. Buch P, Friberg J, Scharling H, Lange P, Prescott E. Reduced lung function and risk of atrial fibrillation in the Copenhagen City Heart Study. The European Respiratory Journal 2003; 21(6): 1012–6
• 9. Wang Q, et al. Smoking as a Risk Factor for the Occurrence of Atrial Fibrillation in Men Versus Women: A Meta-Analysis of Prospective Cohort Studies. Heart, Lung and Circulation (2017):1-8: P58-65
• 10. Tibuakuu M, Kamimura D, Kianoush S, DeFilippis AP, Al Rifai M, Reynolds LM, et al. (2017) The association between cigarette smoking and inflammation: The Genetic Epidemiology Network of Arteriopathy (GENOA) study. PLoS ONE 12(9): e0184914
• 11. Mendall MA, Patel P, Asante M, et al. Relation of serum cytokine concentrations to cardiovascular risk factors and coronary heart disease. Heart 1997; 78:273–7.
• 12. Tappia PS, Troughton KL, Langley-Evans SC, Grimble RF. Cigarette smoking influences cytokine production and antioxidant defenses. Clin Sci (Lond) 1995;88:485–9
• 13. Goncalves RB, Coletta RD, Silverio KG, Benevides L, Casati MZ, da Silva JS, et al. Impact of smoking on inflammation: overview of molecular mechanisms. Inflammation Research 2011;60(5):409–24.
• 14. Rom O, Avezov K, Aizenbud D, Reznick AZ. Cigarette smoking and inflammation revisited. Respir Physiol Neurobiol 2013; 187(1) 5–10
• 15. D’Alessandro A, Boeckelmann I, Hammwhoner M, et al. Nicotine, cigarettes moking and cardiac arrhythmia: an overview. Eur J Prev Cardiol 2012; 19:297–305.
• 16. Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace. 2018 Jan 1;20(1): e1-e160
• 17. Kirchhof P, Bax J, Blomstrom-Lundquist C, Calkins H, Camm AJ, Cappato R, Cosio F, Crijns H, Diener HC, Goette A, Israel CW, Kuck KH, Lip GY, Nattel S, Page RL, Ravens U, Schotten U, Steinbeck G, Vardas P, Waldo A, Wegscheider K, Willems S, Breithardt G. Early and comprehensive management of atrial fibrillation: executive summary of the proceedings from the 2nd AFNET-EHRA consensus conference ‘Research perspectives in AF’. Eur Heart J 2009;30: p2969–2977c
• 18. Andrade J, Khairy P, Dobrev D, Nattel S, The Clinical Profile and Pathophysiology of Atrial Fibrillation Relationships Among Clinical Features, Epidemiology, and Mechanisms, Circ Res. 2014; 114:1453-1468
• 19. Staerk L, Sherer J A, Ko D, Benjamin E J, Helm RH, Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes, Circ Res. 2017 April 28; 120(9): 1501–1517.
• 20. Alonso A, Krijthe BP, Aspelund T, et al. Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population: the CHARGE-AF consortium., J Am Heart Assoc. 2013 Mar 18;2(2): e000102.
• 21. Heeringa J, Kors JA, Hofman A, van Rooij FJ, Witteman JC. Cigarette smoking and risk of atrial fibrillation: the Rotterdam Study. Am Heart J. 2008; 156:1163–9
• 22. Chamberlain AM, Agarwal SK, Folsom AR, Duval S, Soliman EZ, Ambrose M, Eberly LE, Alonso A. Smoking and incidence of atrial fibrillation: results from the Atherosclerosis Risk in Communities (ARIC) study. Heart rhythm: the official journal of the Heart Rhythm Society. 2011; 8:1160–6
• 23. Moliterno DJ, Willard JE, Lange RA, Negus BH, Boehrer JD, Glamann DB, Landau C, Rossen JD, Winniford MD, Hillis LD. Coronary-artery vasoconstriction induced by cocaine, cigarette smoking, or both. N Engl J Med. 1994; 330:454–9.
• 24. Levitzky YS, Guo CY, Rong J, Larson MG, Walter RE, Keaney JF Jr, Sutherland PA, Vasan A, Lipinska I, Evans JC, Benjamin EJ. Relation of smoking status to a panel of inflammatory markers: the framingham offspring. Atherosclerosis. 2008; 201:217–24.
• 25. Buch P, Friberg J, Scharling H, Lange P, Prescott E. Reduced lung function and risk of atrial fibrillation in the Copenhagen City Heart Study. Eur Respir J. 2003; 21:1012–6.
• 26. Shan H, Zhang Y, Lu Y, Zhang Y, Pan Z, Cai B, Wang N, Li X, Feng T, Hong Y, Yang B. Downregulation of miR-133 and miR-590 contributes to nicotine-induced atrial remodelling in canines. Cardiovasc Res. 2009; 83:465–72
• 27. Frustaci A, Chimenti C, Bellocci F, Morgante E, Russo MA, Maseri A. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation 1997;96: 1180– 1184
• 28. Nakamura Y, Nakamura K, Fukushima-Kusano K, Ohta K et all. Tissue factor expression in atrial endothelium associated with nonvalvular atrial fibrillation: possible involvement in intracardiac thrombogenesis. Thromb Res 2003;111: 137142. 66
• 29. Aviles RJ, Martin DO, Apperson-Hansen C, Houghtaling PL, Rautaharju P, Kronmal RA, Tracy RP, Van Wagoner DR, Psaty BM, Lauer MS, Chung MK. Inflammation as a risk factor for atrial fibrillation. Circulation. 2003 Dec 16; 108(24): 3006-10.
• 30. Boos CJ, Anderson RA, Lip GY. Is atrial fibrillation an inflammatory disorder? Eur Heart J. 2006 Jan;27(2):136-49.
• 31. Asselbergs FW, van den Berg MP, Diercks GF, van Gilst WH, van Veldhuisen DJ. Creactive protein and microalbuminuria are associated with atrial fibrillation. Int J Cardiol 2005;98: 73–77
• 32. Psychari SN, Apostolou TS, Sinos L, Hamodraka E, Liakos G, Kremastinos DT. Relation of elevated C-reactive protein and interleukin-6 levels to left atrial size and duration of episodes in patients with atrial fibrillation. Am J Cardiol 2005; 95: 764–767).
• 33. Zahorec R., Neutrophil-to-lymphocyte ratio. Sixteen-year-long history since publication of our article in Bratislava Medical Journal, 321-323
• 34. Bermudez EA, Rifai N, Buring JE, Manson JE, Ridker PM. Relation between markers of systemic vascular inflammation and smoking in women. Am J Cardiol 2002; 89:1117–9
• 35. Wada H, Dohi T, Miyauchi K, Doi S, Naito R, Konishi H, et al. Independent and combined effects of serum albumin and C-reactive protein on longterm outcomes of patients undergoing percutaneous coronary intervention. Circ J. 2017;81(9):1293-300
• 36. Joles JA, Willekes-Koolschijn N, Koomans HA. Hypoalbuminemia causes high blood viscosity by increasing red cell lysophosphatidylcholine. Kidney Int. 1997;52(3):761-70
• 37. Van Beek DEC, Kuijpers YAM, Königs MHH, van der Horst ICC, Scheeren TWL., Low serum albumin levels and new-onset atrial fibrillation in the ICU: a prospective cohort study J Crit Care. 2020 Apr; 56:26-30
• 38. Nelson JJ, Liao D, Sharrett AR, Folsom AR, Chambless LE, Shahar E, et al. Serum albumin level as a predictor of incident coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol. 2000; 151:468–77
• 39. Yu ST, Zhou Z, Cai Q, et al. Prognostic value of the C-reactive protein/albumin ratio in patients with laryngeal squamous cell carcinoma. Onco Targets Ther 2017; 10:879-84
• 40. Liu Z, Jin K, Guo M, et al. Prognostic value of the CRP/Alb ratio, a novel inflammation-based score in pancreatic cancer. Ann Surg Oncol 2017; 24:561-8).
• 41. Fairclough E, Cairns E, Hamilton J, Kelly C. Evaluation of a modified early warning system for acute medical admissions and comparison with Creactive protein/albumin ratio as a predictor of patient outcome. Clin Med. 2009; 9:30-3
• 42. Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-Reactive Protein/Albumin Ratio Predicts 90-Day Mortality of Septic Patients. Salluh JIF, editor. PLoS One. 2013; 8: e59321
• 43. Kinoshita A, Onoda H, Imai N, Iwaku A, Oishi M, Tanaka K, et al. The C-reactive protein/albumin ratio, a novel inflammation-based prognostic score, predicts outcomes in patients with hepatocellular carcinoma. Ann Surg Oncol. 2015; 22:803–10
• 44. Kalyoncuoglu M, Durmus G. Relationship between C-reactive protein-to-albumin ratio and the extent of coronary artery disease in patients with non-ST-elevated myocardial infarction. Coron Artery Dis. 2020;31(2):130-6