Echocardiographic and Biochemical Factors Predicting Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation—An Observational Study
Background: RFA is a well-established treatment for symptomatic patients with AF. However, the success rate of a single procedure is low. We aimed to investigate the association between the risk of recurrence of atrial fibrillation (AF) after a single radiofrequency ablation (RFA) procedure and card...
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doaj-a212b48f133647c9bf0cbbd5855b8dc42020-11-25T02:45:42ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2019-10-011010.3389/fphys.2019.01215479167Echocardiographic and Biochemical Factors Predicting Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation—An Observational StudyEmmanouil Charitakis0Lars O. Karlsson1Joanna-Maria Papageorgiou2Ulla Walfridsson3Carl-Johan Carlhäll4Carl-Johan Carlhäll5Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, SwedenDepartment of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, SwedenDepartment of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, SwedenDepartment of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, SwedenDivision of Cardiovascular Medicine and CMIV, Linköping University, Linköping, SwedenDepartment of Clinical Physiology and Department of Medical and Health Sciences, Linköping University, Linköping, SwedenBackground: RFA is a well-established treatment for symptomatic patients with AF. However, the success rate of a single procedure is low. We aimed to investigate the association between the risk of recurrence of atrial fibrillation (AF) after a single radiofrequency ablation (RFA) procedure and cardiac neurohormonal function, left atrial (LA) mechanical function as well as proteins related to inflammation, fibrosis, and apoptosis.Methods and Results: We studied 189 patients undergoing RFA between January 2012 and April 2014, with a follow-up period of 12 months. A logistic regression analysis was performed to investigate the association between pre-ablation LA emptying fraction (LAEF), MR-proANP, Caspase-8 (CASP8), Neurotrophin-3 (NT3), and the risk for recurrence of AF after a single RFA procedure. 119 (63.0%) patients had a recurrence during a mean follow-up of 402 ± 73 days. An increased risk of recurrence was associated with: Elevated MR-proANP (fourth quartile vs. first quartile: HR, 2.80 (95% CI, 1.14–6.90]; P = 0.025); Low LAEF (fourth quartile vs. first quartile: hazard ratio [HR], 2.41 [95% CI, 1.01–5.79]; P = 0.045); Elevated CASP8 (fourth quartile vs. first quartile: HR 12.198 95% CI 2.216–67.129; P = 0.004); Elevated NT-3 (fourth quartile vs. first quartile: HR 7.485 95% CI 1.353–41.402; P = 0.021). In a receiver operating characteristic curve analysis, the combination of MR-proANP, CASP8, and NT3 produced an area under the curve of 0.819; CI 95% (0.710–0.928).Conclusions: Patients with better LA mechanical function and lower levels of atrial neurohormones as well as of proteins related to fibrosis and apoptosis, have a better outcome after an RFA procedure.Unique identifier: No. NCT01553045 (https://clinicaltrials.gov/ct2/show/NCT01553045?term=NCT01553045&rank=1).https://www.frontiersin.org/article/10.3389/fphys.2019.01215/fullatrial fibrillationradiofrequency ablationnatriuretic peptidesleft atrial emptying fractionfibrosisapoptosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Emmanouil Charitakis Lars O. Karlsson Joanna-Maria Papageorgiou Ulla Walfridsson Carl-Johan Carlhäll Carl-Johan Carlhäll |
spellingShingle |
Emmanouil Charitakis Lars O. Karlsson Joanna-Maria Papageorgiou Ulla Walfridsson Carl-Johan Carlhäll Carl-Johan Carlhäll Echocardiographic and Biochemical Factors Predicting Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation—An Observational Study Frontiers in Physiology atrial fibrillation radiofrequency ablation natriuretic peptides left atrial emptying fraction fibrosis apoptosis |
author_facet |
Emmanouil Charitakis Lars O. Karlsson Joanna-Maria Papageorgiou Ulla Walfridsson Carl-Johan Carlhäll Carl-Johan Carlhäll |
author_sort |
Emmanouil Charitakis |
title |
Echocardiographic and Biochemical Factors Predicting Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation—An Observational Study |
title_short |
Echocardiographic and Biochemical Factors Predicting Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation—An Observational Study |
title_full |
Echocardiographic and Biochemical Factors Predicting Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation—An Observational Study |
title_fullStr |
Echocardiographic and Biochemical Factors Predicting Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation—An Observational Study |
title_full_unstemmed |
Echocardiographic and Biochemical Factors Predicting Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation—An Observational Study |
title_sort |
echocardiographic and biochemical factors predicting arrhythmia recurrence after catheter ablation of atrial fibrillation—an observational study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Physiology |
issn |
1664-042X |
publishDate |
2019-10-01 |
description |
Background: RFA is a well-established treatment for symptomatic patients with AF. However, the success rate of a single procedure is low. We aimed to investigate the association between the risk of recurrence of atrial fibrillation (AF) after a single radiofrequency ablation (RFA) procedure and cardiac neurohormonal function, left atrial (LA) mechanical function as well as proteins related to inflammation, fibrosis, and apoptosis.Methods and Results: We studied 189 patients undergoing RFA between January 2012 and April 2014, with a follow-up period of 12 months. A logistic regression analysis was performed to investigate the association between pre-ablation LA emptying fraction (LAEF), MR-proANP, Caspase-8 (CASP8), Neurotrophin-3 (NT3), and the risk for recurrence of AF after a single RFA procedure. 119 (63.0%) patients had a recurrence during a mean follow-up of 402 ± 73 days. An increased risk of recurrence was associated with: Elevated MR-proANP (fourth quartile vs. first quartile: HR, 2.80 (95% CI, 1.14–6.90]; P = 0.025); Low LAEF (fourth quartile vs. first quartile: hazard ratio [HR], 2.41 [95% CI, 1.01–5.79]; P = 0.045); Elevated CASP8 (fourth quartile vs. first quartile: HR 12.198 95% CI 2.216–67.129; P = 0.004); Elevated NT-3 (fourth quartile vs. first quartile: HR 7.485 95% CI 1.353–41.402; P = 0.021). In a receiver operating characteristic curve analysis, the combination of MR-proANP, CASP8, and NT3 produced an area under the curve of 0.819; CI 95% (0.710–0.928).Conclusions: Patients with better LA mechanical function and lower levels of atrial neurohormones as well as of proteins related to fibrosis and apoptosis, have a better outcome after an RFA procedure.Unique identifier: No. NCT01553045 (https://clinicaltrials.gov/ct2/show/NCT01553045?term=NCT01553045&rank=1). |
topic |
atrial fibrillation radiofrequency ablation natriuretic peptides left atrial emptying fraction fibrosis apoptosis |
url |
https://www.frontiersin.org/article/10.3389/fphys.2019.01215/full |
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