Hemoglobin Levels as a Marker of Arrhythmia Recurrence After Atrial Fibrillation Ablation

Figures

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  FIGURE 1. Impact of baseline hemoglobin levels on arrhythmia recurrence after radiofrequency ablation. (A) Kaplan–Meier curves for atrial fibrillation/atrial tachycardia recurrence after the index RFA procedure according to baseline Hb levels. Patients in the lowest quartile (Q1: Hb < 12.4 g/dL) had a significantly higher incidence of recurrence compared with those in the higher quartiles (Q2–4: Hb ≥ 12.4 g/dL) (adjusted HR 1.33, 95% CI 1.07–1.65; log‐rank p = 0.009). (B) Distribution of the number of reconnected PVs at the time of repeat ablation after RFA. No significant difference was observed between the Q1 and Q2–4 groups (p = 0.383). (C) Kaplan–Meier curves for recurrence after multiple ablation sessions landmarked at the completion of the final procedure. Patients in the Q1 group remained at higher risk of recurrence compared with those in the Q2–4 group (adjusted HR 1.57, 95% CI 1.22–2.02; log‐rank p < 0.001). HRs were adjusted for age, sex, AF type, chronic kidney disease, and left atrial diameter. AF, atrial fibrillation; Hb, hemoglobin; PV, pulmonary vein; RFA, radiofrequency ablation.

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  FIGURE 2. Association between baseline hemoglobin and arrhythmia recurrence after cryoballoon ablation, and effect of lower hemoglobin according to ablation modality. (A) Kaplan–Meier curves for recurrence of atrial fibrillation/atrial tachycardia beyond the 90‐day blanking period in the CBA cohort, comparing the lower‐Hb group (Hb < 12.4 g/dL) and the non‐low Hb group (Hb ≥ 12.4 g/dL). The cut‐off (12.4 g/dL) was derived from the RFA cohort. (B) Forest plot showing adjusted hazard ratios for recurrence (lower‐Hb vs. non‐low Hb) stratified by ablation modality. In the RFA cohort, lower‐Hb was significantly associated with higher recurrence, whereas the association was not significant in the CBA cohort. The modality × hemoglobin interaction was not statistically significant (p for interaction = 0.177). HRs were adjusted for age, sex, AF type, chronic kidney disease, BNP and left atrial diameter. CBA, cryoballoon ablation; other abbreviations are shown in Figure 1.