Clinical InvestigationElectrophysiologyNatriuretic peptide levels predict recurrence of atrial fibrillation after radiofrequency catheter ablation
Section snippets
Patient population and evaluation
The study population included patients with drug-refractory symptomatic paroxysmal AF and preserved LV systolic function (ejection fraction >50%) who were referred for RFCA. Atrial fibrillation was classified as paroxysmal when episodes were generally self-terminating and lasted no longer than 7 days, according to the American College of Cardiology/American Heart Association/European Society of Cardiology guidelines definitions.11 At admission, a blood sample was obtained to measure natriuretic
Patient characteristics
The present patient population was prospectively included from an ongoing clinical registry.14 Of 140 consecutive patients undergoing catheter ablation for AF, 87 patients were in SR during the baseline blood test and comprised the patient population (70 men [80%], mean age 55.0 ± 9.4 years). None of the patients previously underwent RFCA for AF. Mean duration of AF was 65 ± 60 months and the mean number of antiarrhythmic drugs used was 3.4 ± 1.4 per patient. Mean LA volume index was 42 ± 12
Discussion
The present study investigated the role of natriuretic peptides to predict AF recurrence after RFCA in patients without signs of structural heart disease. The main finding was that pre-procedural NT-proBNP plasma level was an independent predictor of AF recurrence after RFCA. Importantly, NT-proBNP plasma level had an incremental value over echocardiographic parameters to predict the AF recurrence after RFCA.
Conclusion
In patients without signs of overt structural heart disease, baseline NT-proBNP plasma level obtained during SR is an independent predictor of AF recurrence after RFCA. Plasma levels of NT-proBNP may allow detection of subtle cardiac dysfunction/conditions that may not be detected by echocardiography alone.
Disclosures
Martin J. Schalij receives research grants from Boston Scientific (Natick, MA), Medtronic (Minneapolis, MN), and Biotronik (Berlin, Germany). Jeroen J. Bax receives research grants from General Electric Healthcare (Buckinghamshire, UK), Bristol-Myers Squibb Medical Imaging (North Billerica, MA), St Jude Medical (St. Paul, MN), Medtronic, Boston Scientific, Biotronik, and Edwards Lifesciences (Irvine, CA). The remaining authors have no conflicts of interest to disclose.
Acknowledgements
We thank Margreet de Jong for performing the biochemical analyses.
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