title: A pre-existent elevated C-reactive protein is associated with the recurrence of atrial tachyarrhythmias after catheter ablation in patients with atrial fibrillation.
abstract: OBJECTIVE
  It has been reported that an inflammatory process is involved in the development of atrial fibrillation (AF). In this study, we examined the hypothesis that a pre-existent inflammatory response may enhance the recurrence of AF after catheter ablation (CA).
  
  
  RESULTS
  A total of 257 consecutive AF patients undergoing CA were enrolled in this study. The C-reactive protein was assessed by a high-sensitive radio-immunoassay 1 day before the procedure. Of the clinical characteristics, an advanced age, structural heart disease, and the left atrial (LA) diameter were significantly increased when the C-reactive protein level was elevated. Atrial fibrillation occurrences were significantly increased when the C-reactive protein level was elevated. A multivariate analysis demonstrated that an elevated C-reactive protein level [hazard ratio (95% CI); 2.23 (1.04-4.35)], the LA diameter [1.26 (1.10-1.66)], and persistent AF duration [2.13 (1.13-3.79)] were independent factors related to the recurrence of AF after CA. In the procedural findings, burst-inducible AF after pulmonary vein (PV) isolation was significantly increased, and the incidence of AF from the PVs was significantly lower when the C-reactive protein level was elevated.
  
  
  CONCLUSIONS
  An elevated C-reactive protein level was associated with atrial structural and electrical remodelling maintaining AF, and the increased re-entrant atrial substrate might increase the recurrence of AF after the CA procedure.
authors.affiliation: Division of Cardiac Rhythm Management, Shiroyama Hospital, Habikino City, Osaka 583-0872, Japan. kurotobi-circ@umin.ac.jp
authors.forename: Toshiya
authors.initials: T
authors.lastname: Kurotobi
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Iwakura
authors.forename: Koichi
authors.initials: K
authors.lastname: Inoue
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Kimura
authors.forename: Atsunori
authors.initials: A
authors.lastname: Okamura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Koyama
authors.forename: Yuko
authors.initials: Y
authors.lastname: Toyoshima
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ito
authors.forename: Kenshi
authors.initials: K
authors.lastname: Fujii
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D002097:C-Reactive Protein / Q000032:analysis*; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011863:Radioimmunoassay; D012008:Recurrence; D013610:Tachycardia / Q000097:blood* / Q000503:physiopathology
chemical_list: D002097:C-Reactive Protein