Increased NT-pro-B-type natriuretic peptide independently predicts outcome following catheter ablation of atrial fibrillation.
OBJECTIVE
To investigate whether NT-proBNP before ablation treatment and after exercise testing has predictive information regarding the clinical outcome following pulmonary vein isolation in patients with atrial fibrillation (AF).


METHODS
NT-proBNP analysis were obtained before the ablation (before and after exercise test), and repeated at 1, 3, and 12 months after the final procedure.


RESULTS
A total of 51 patients were included. At study entry, the median NT-proBNP concentration was 14.0 pmol/L (quartiles: 8.0 and 27.0). After the exercise test, the mean NT-proBNP value increased from 13.0 pmol/L (quartiles: 7.5 and 26.0) to 15.0 pmol/L (quartiles: 9.0 and 34.0), p < 0.001. Following a maximum of two ablations, 22 patients were free of AF while 29 patients experienced recurrent AF. In patients with successful ablation, the mean NT-proBNP concentration at baseline was 10.0 pmol/L (quartiles: 7.0 and 22.2) compared to 22.0 pmol/L (quartiles: 12.0 and 34.5) in patients with ablation failure, p = 0.02. With respect to exercise testing, a trend towards a higher increases during exercise were seen in patients with recurrent AF compared to patients without: 2.0 pmol/L (quartiles 1.9 and 7.0) vs. 1.5 pmol/L (quartiles 0 and 3.0), p = 0.07. A baseline NT-proBNP concentration >15.0 pmol/L was found to be an independent predictor of ablation failure.


CONCLUSIONS
A significantly lower NT-proBNP concentration at baseline and a trend towards a diminished increase during exercise was seen in patients successfully ablated for AF compared to patients with recurrent AF. A baseline NT-proBNP concentration <or=15 pmol/l independently predicts ablation success.
Nilsson
Brian
B
Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen. brni@dadlnet.dk
Goetze
Jens Peter
JP
Chen
Xu
X
Pehrson
Steen
S
Svendsen
Jesper Hastrup
JH
D001281:Atrial Fibrillation / Q000097:blood* / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012008:Recurrence; D016896:Treatment Outcome
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain