title: Difference in humoral biomarkers for myocardial injury and inflammation in radiofrequency ablation versus cryoablation.
abstract: BACKGROUND
  Markers of myocardial injury and inflammation have been shown to be elevated following radiofrequency (RF) ablation. This study aimed to compare RF ablation and cryoablation for their impact on markers for myocardial injury and inflammation.
  
  
  METHODS
  Nineteen patients received catheter ablation for atrial flutter by either cryoablation (10 patients) or open-irrigated RF ablation (nine patients). Venous blood samples for troponin T (TnT), creatinkinase (CK), and the cardiac isoenzyme MB (CKMB) were obtained before, at six hours after the end of ablation, and the following day. C-reactive protein (CRP) levels were measured before ablation and the following day.
  
  
  RESULTS
  Bidirectional isthmus block was achieved in all patients. Cryoablation showed significantly higher TnT following ablation (0.85 microg/l +/- 0.39 microg/l) compared to RF ablation (0.36 microg/l +/- 0.24 microg/l; p= 0.01) with declining levels the following day (cryoablation: 0.58 microg/l +/- 0.20 microg/l; RF ablation 0.34 microg/l +/- 0.21 microg/l; p= 0.03). We observed equal findings for CK and CKMB, both significantly higher in cryoablation. RF ablation led to a nonsignificant rise in CK and CKMB. CRP was elevated significantly higher following RF ablation (12.3 mg/dl +/- 4.1 mg/dl) compared to cryoablation (6.9 mg/dl +/- 4.0 mg/dl; p= 0.01).
  
  
  CONCLUSIONS
  We show reduced inflammation despite higher markers for myocardial injury in cryoablation. The difference in biomarkers reflects different lesion formation in cryoablation and RF ablation. Cryoablation shows less systemic inflammatory reaction. This might be due to less endothelial damage and surface thrombosis in cryoablation.
authors.affiliation: Department of Cardiovascular Medicine, Hannover Medical School, Hannover, Germany. hanno_oswald@gmx.de
authors.forename: Hanno
authors.initials: H
authors.lastname: Oswald
authors.forename: Ajmal
authors.initials: A
authors.lastname: Gardiwal
authors.forename: Christoph
authors.initials: C
authors.lastname: Lissel
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.forename: Gunnar
authors.initials: G
authors.lastname: Klein
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000097:blood* / Q000601:surgery*; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D017115:Catheter Ablation; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D003452:Cryosurgery; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000097:blood; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D020107:Troponin T; D002097:C-Reactive Protein; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form