Improved endothelial function in patients with atrial fibrillation through maintenance of sinus rhythm by successful catheter ablation.
BACKGROUND
Although atrial fibrillation (AF) is a risk factor for endothelial dysfunction (ED), the effect of catheter ablation (CA) on AF-associated ED has not been evaluated. The aims of this study are to determine if the degree of ED predicts the outcome of AF ablation and to evaluate whether ED can be improved through restoring sinus rhythm (SR) by successful CA.


METHODS
This study prospectively enrolled 80 subjects who underwent CA for AF (paroxysmal AF = 61, persistent AF = 19). Eighty subjects with no history of AF were enrolled as controls, all of whom were matched by age, gender, body mass index, and atherosclerotic risk factor distribution. Brachial artery flow-mediated dilatation (FMD) was measured at baseline, and at 1 month and 6 months post CA in AF subjects who remained in SR. Among controls, FMD was measured at baseline and at 6 months. We used high sensitivity C-reactive protein (hs-CRP), interleukin-6, soluble E- or P-selectin, and endothelin-1 as biomarker indices for inflammation and/or ED.


RESULTS
Compared with controls, AF subjects had lower FMD at baseline (FMD(baseline), P < 0.001). After successful CA, FMD was significantly improved at 1 month and 6 months, nearly approaching control levels. A multivariate analysis revealed that FMD(baseline), hs-CRP, and left atrial volume (LAV) were independent predictors for arrhythmia recurrence after CA. Other biomarkers were not related to rhythm outcome.


CONCLUSIONS
AF subjects have significantly impaired FMD, which can be reversed through maintenance of SR by successful CA. FMD(baseline), hs-CRP, and LAV are important predictors for AF recurrence after CA.
Division of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Guro-gu, Seoul, Korea.
Seung Yong
SY
Shin
Jin Oh
JO
Na
Hong Euy
HE
Lim
Cheol Ung
CU
Choi
Jong Il
JI
Choi
Seong Hwan
SH
Kim
Eung Ju
EJ
Kim
Sang Weon
SW
Park
Seung-Woon
SW
Rha
Chang Gyu
CG
Park
Hong Seog
HS
Seo
Dong Joo
DJ
Oh
Young-Hoon
YH
Kim
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012849:Sinoatrial Node / Q000502:physiology*; D016896:Treatment Outcome