Efficacy of catheter treatment of atrial fibrillation in patients with myocarditis depending on the adrenoreaction of the body (a prospective single-center study)

Background. Worldwide, research continues into various factors that may influence the success of catheter treatment of atrial fibrillation. In this regard, the influence of the state of the sympathoadrenal system of the body has not been studied enough. Aims — to evaluate the effectiveness of interventional treatment of atrial fibrillation (AF) in patients with and without myocarditis, depending on the level of beta-adrenergic responsiveness of the organism. Materials and methods. The study sample included 40 patients. Of these, 27 (67.5%) are men. The age in the sample was 49 (44; 55) years. The study included 25 (62.5%) patients with paroxysmal AF, 10 (25.0%) with persistent and 5 (12.5%) with long-term persistent. All patients underwent surgical treatment of AF using radiofrequency (RFA) or cryoablation (CBA). Endomyocardial biopsy was performed in 18 patients to verify the diagnosis. Beta-adrenergic responsiveness (beta-ARM) was assessed in dynamics 3 days after surgery, 3 months and 12 months. The follow-up period for patients was 12 months. Results. All patients underwent surgical treatment of AF, in 7 cases (17.5%) CBA of the pulmonary veins was performed, in 33 (82.5%) cases RFA was performed. According to the biopsy results, signs of myocarditis were detected in 9 patients (22.5%). Focal myocarditis was found in 7 patients, diffuse — in 2. The effectiveness of catheter treatment in general was 72.5%, for CBA — 71.5%, for RFA — 73.5%. Beta-ARM before ablation was 19.16% [12.46; 27.46], 3 days after ablation — 24.43% [15.38; 33.65], after 3 months was 20.27% [9.90; 27.71], in 4 patients after 12 months, beta-ARM was 32.5% [20.0; 43.2]. The dynamics and influence of beta-ARM on the effectiveness of interventional treatment of AF in patients with early and late relapses, the presence of myocarditis was assessed. Conclusions. The results obtained showed no effect of the level of beta-ARM on the effectiveness of RFA and CBA in patients with and without myocarditis. Beta-ARM showed no association with the development of early arrhythmia recurrences after ablation. No statistically significant differences were found when comparing beta-ARM levels in patients with and without diagnosed myocarditis.