Association between T cell exhaustion and the recurrence of atrial fibrillation after cryoballoon ablation

Background: Atrial fibrillation (AF) recurrence remains a challenge after Cryoballoon ablation (CBA). To date, few studies have investigated the impact of immunosenescence, particularly exhausted T cells, on AF recurrence after CBA. This study aims to investigate the association between exhausted T cells and AF recurrence after CBA, and to develop a novel model for the prediction of AF recurrence. Methods: Clinical data of patients undergoing CBA treatment for AF at Tianjin Medical University Second Hospital from March to November 2022 were collected, and AF recurrence was followed up. Flow cytometry was employed to evaluate the levels of inhibitory receptors (IR) on exhausted T cells, including killer cell lectin-like receptor G1 (KLRG1), programmed death-1 (PD-1), T cell immunoglobulin and mucin domain-containing molecule 3 (Tim-3), lymphocyte activation gene 3 (LAG-3), CD27, and CD57. Variables selected through Lasso regression analyses were incorporated into a multivariable Cox proportional hazards model to validate and identify independent risk factors for AF recurrence, building two predictive models. The efficacy of the two models was assessed using Receiver Operating Characteristic (ROC) curves, calibration curves, and Decision Curve Analysis (DCA). Results: Tnaive. Validation of both models revealed that Model 2 showed better predictive performance, and a nomogram was created to present the results visually. Conclusion: Tnaive as key variables, which can enhance the predictive value for AF recurrence in patients after CBA surgery.