title: Role of tissue C-reactive protein in atrial cardiomyocytes of patients undergoing catheter ablation of atrial fibrillation: pathogenetic implications.
abstract: OBJECTIVE
  Histological studies support the important role of inflammation in the initiation and maintenance of atrial fibrillation (AF). We describe a novel and safe technique of atrial biopsy during AF radiofrequency catheter ablation (RFCA) to investigate the role of atrial tissue inflammation.
  
  
  RESULTS
  We enrolled 70 consecutive patients (age 60 ± 12 years, 49 males) undergoing RFCA for AF. The control group was represented by 10 patients with Wolff-Parkinson-White syndrome undergoing trans-septal puncture. Atrial biopsies were obtained by washing the dilator and needle used for trans-septal puncture with 20 mL sterile phosphate-buffered saline. The presence of intracytoplasmic C-reactive protein was assessed in formalin-fixed atrial specimens by immunohistochemistry. A sufficient amount of atrial tissue was obtained in 23/70 (32%) patients with AF and in 4/10 (40%) of the control group. Intracytoplasmic localization of C-reactive protein was found in isolated atrial cardiomyocytes in 11 (73%) of 15 patients with paroxysmal AF as compared with 2 (25%) of eight patients with persistent AF (P= 0.02).
  
  
  CONCLUSIONS
  In this study, we demonstrate the safety and feasibility of a novel technique to obtain atrial specimens during routine trans-septal puncture. Local inflammation assessed by atrial tissue localization of C-reactive protein is more likely involved in paroxysmal rather than in persistent AF.
authors: Institute of Cardiology, Catholic University of Sacred Heart, Rome, Italy. lianarducci@yahoo.it
authors: Maria Lucia
authors: ML
authors: Narducci
authors: Gemma
authors: G
authors: Pelargonio
authors: Antonio
authors: A
authors: Dello Russo
authors: Michela
authors: M
authors: Casella
authors: Luigi Marzio
authors: LM
authors: Biasucci
authors: Giuseppe
authors: G
authors: La Torre
authors: Vincenzo
authors: V
authors: Pazzano
authors: Pasquale
authors: P
authors: Santangeli
authors: Alfonso
authors: A
authors: Baldi
authors: Giovanna
authors: G
authors: Liuzzo
authors: Claudio
authors: C
authors: Tondo
authors: Andrea
authors: A
authors: Natale
authors: Filippo
authors: F
authors: Crea
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy / Q000379:methods*; D002097:C-Reactive Protein / Q000378:metabolism*; D017115:Catheter Ablation; D003593:Cytoplasm / Q000378:metabolism; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000378:metabolism / Q000473:pathology*; D032383:Myocytes, Cardiac / Q000378:metabolism / Q000473:pathology*; D011446:Prospective Studies; D014927:Wolff-Parkinson-White Syndrome / Q000378:metabolism / Q000473:pathology / Q000601:surgery
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein