To the Editor,
I read with great interest the author’s letter about our article entitles “Prediction of recurrence after cryoballoon ablation therapy in patients with paroxysmal atrial fibrillation” in Anatol J Cardiol, 2015 Sep 15 Epub of ahead of print.
As you said, different antiarrhythmic drugs have different efficacy for maintaining sinus rhythm. In our study, only one patient of the ablated population was using amiodarone in the preablation period; however, he discontinued this drug approximately 1 month before the ablation. The remaining patients were those who could not use any antiarrhythmic therapy. Therefore, we did not analyze the antiarrhythmic effect on recurrence because only one patient was using amiodarone. All the patients were discharged with the use of antiarrhythmic therapy after cryoablation, and on the 3-month follow-up visit, use of the antiarrhythmic drug was stopped. Amiodarone is the only available oral antiarrhythmic agent in our country; therefore, the patients used amiodarone during the 3 months after the procedure. Because all patients took the same drug using the same dose schema, an effect on the recurrence cannot be expected.
As you have mentioned, there are studies underlining the significance of left atrial strain measurements in the prediction of AF recurrence. You are right; left atrial deformation parameters measured with 2-D speckle tracking method could be included in our study. However, this method is considered as a further investigation and is not easily available; in addition, it requires special software. For these reasons, we think that the parameters, which we analyzed and suggested to be used in the prediction of AF recurrence, are more feasible and common.