Journal of arrhythmia · 2026
Association Between the Change in Interleukin-6 Levels and Early Recurrence of Atrial Fibrillation: A Comparison of Pulsed Field Ablation and Radiofrequency Ablation.
СтатьяНазвание и аннотация: Перевод в очереди
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Watanabe Ken, Arimoto Takanori, Toyoshima Mashu, Koyama Kyoko, Kobayashi Yuta, Hashimoto Naoaki, Watanabe Masafumi
Аннотация
BACKGROUND: Early recurrence of atrial fibrillation (ERAF) within the 3-month blanking period is associated with procedural inflammation and increased risk of late recurrence. Pulsed field ablation (PFA) reportedly has a lower ERAF rate than radiofrequency ablation (RFA), but the underlying inflammatory mechanisms remain unclear.
METHODS: We compared 23 patients undergoing atrial fibrillation ablation (PFA: n = 16; RFA: n = 7). Perioperative changes in inflammatory markers, myocardial injury markers, hemolysis markers, and the incidence of ERAF were analyzed.
RESULTS: PFA exhibited significantly greater myocardial injury and hemolysis, but markedly lower systemic inflammation than RFA, characterized by lower Δinterleukin-6 (IL-6) levels (4.6 ± 1.7 vs. 8.1 ± 3.8 pg/mL, p = 0.008). ERAF occurred more frequently in RFA (3/7, 43% vs. 1/16, 6%, p = 0.033), which was accompanied by significantly higher ΔIL-6 levels (9.1 ± 4.2 vs. 4.9 ± 2.3 pg/mL, p = 0.010). Multivariate logistic regression analysis identified ΔIL-6 as an independent predictor of ERAF (OR 2.158, 95% CI 1.125-13.020, p = 0.013).
CONCLUSIONS: PFA induces less systemic inflammation than RFA, despite causing greater myocardial injury. This reduced inflammatory response is independently associated with the lower incidence of ERAF.
METHODS: We compared 23 patients undergoing atrial fibrillation ablation (PFA: n = 16; RFA: n = 7). Perioperative changes in inflammatory markers, myocardial injury markers, hemolysis markers, and the incidence of ERAF were analyzed.
RESULTS: PFA exhibited significantly greater myocardial injury and hemolysis, but markedly lower systemic inflammation than RFA, characterized by lower Δinterleukin-6 (IL-6) levels (4.6 ± 1.7 vs. 8.1 ± 3.8 pg/mL, p = 0.008). ERAF occurred more frequently in RFA (3/7, 43% vs. 1/16, 6%, p = 0.033), which was accompanied by significantly higher ΔIL-6 levels (9.1 ± 4.2 vs. 4.9 ± 2.3 pg/mL, p = 0.010). Multivariate logistic regression analysis identified ΔIL-6 as an independent predictor of ERAF (OR 2.158, 95% CI 1.125-13.020, p = 0.013).
CONCLUSIONS: PFA induces less systemic inflammation than RFA, despite causing greater myocardial injury. This reduced inflammatory response is independently associated with the lower incidence of ERAF.