A pre-existent elevated C-reactive protein is associated with the recurrence of atrial tachyarrhythmias after catheter ablation in patients with atrial fibrillation.
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.
Kurotobi
Toshiya
T
Division of Cardiac Rhythm Management, Shiroyama Hospital, Habikino City, Osaka 583-0872, Japan. kurotobi-circ@umin.ac.jp
Iwakura
Katsuomi
K
Inoue
Koichi
K
Kimura
Ryusuke
R
Okamura
Atsunori
A
Koyama
Yasushi
Y
Toyoshima
Yuko
Y
Ito
Norihisa
N
Fujii
Kenshi
K
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
D002097:C-Reactive Protein