Diagnostic accuracy of cardiac markers for myocardial damage after radiofrequency catheter ablation.
OBJECTIVE
This study compares serum markers of myocardial damage incurred during radiofrequency catheter ablation (RFCA).


RESULTS
Blood was sampled from 34 patients with atrial flutter (n = 16), atrioventricular nodal reentrant tachycardia (AVNRT; n = 13), and Wolff-Parkinson-White syndrome (WPW; n = 5) to measure creatine kinase MB subfraction (CK-MB), human heart-type fatty acid protein (h-FABP), and cardiac troponin T (cTnT) values at baseline and after RFCA. The controls comprised 12 patients without significant elevation of all myocardial markers during electrophysiological study (EPS) without RFCA. h-FABP values did not elevate significantly, whereas CK-MB and cTnT demonstrated significant change after RFCA (P < 0.001). Neither peak h-FABP nor CK-MB correlated with following RFCA parameters: delivery duration, number of RFCA discharges, and cumulative RFCA energy. In contrast, correlations were significant between mean peak values of cTnT and these RFCA parameters (all P < 0.05). The sensitivity (71.6%) and specificity (35.6%) of h-FABP were inferior to those of cTnT (93.3% and 89.8%, respectively).


CONCLUSIONS
h-FABP is an insensitive and less specific marker of myocardial damage in RFCA much along the lines of CK-MB and when compared with the proven accuracy of cTnT.
Hirose
Hideo
H
Department of Cardiovascular Medicine, Gifu Prefectural Government TAJIMI Hospital, Tajimi, Gifu 5078522, Japan.
Kato
Kimihiko
K
Suzuki
Osamu
O
Yoshida
Tetsuro
T
Oguri
Mitsutoshi
M
Yajima
Kazuhiro
K
Hibino
Takeshi
T
Yokoi
Kiyoshi
K
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000601:surgery*; D001282:Atrial Flutter / Q000601:surgery; D015415:Biomarkers / Q000032:analysis*; D017115:Catheter Ablation / Q000009:adverse effects*; D052279:Creatine Kinase, MB Form / Q000097:blood*; D022062:Electrophysiologic Techniques, Cardiac; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery; D020107:Troponin T / Q000097:blood*; D014927:Wolff-Parkinson-White Syndrome / Q000601:surgery
D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D020107:Troponin T; D052279:Creatine Kinase, MB Form