title: Impact of prophylactic corticosteroids on systemic inflammation after extensive atrial ablation in pigs.
abstract: OBJECTIVE
  Prophylactic corticosteroids have been reported to attenuate the increase in C-reactive protein (CRP) and the incidence of atrial fibrillation (AF) both after heart surgery and AF ablation. We tested the impact of a single prophylactic corticosteroid dose on ultrasensitive CRP 24 h and 14 days after extensive linear atrial ablation (8 mm or 3.5 irrigated tip) guided by electroanatomical mapping (NavX) in pigs with normal hearts.
  
  
  RESULTS
  Pigs (n = 19; 35 kg) were divided into three groups: corticoid (n = 7), atrial ablation with administration of 500 mg methylprednisolone intravenous at anaesthetic induction; control (n = 7), atrial ablation only; and sham (n = 5), surgical procedure without ablation. Troponin and CRP were measured before, 24 h and 14 days after the procedure. After sacrifice, lesions were analysed macroscopically and histologically. Linear lesions were created in the right (n = 23) and left (n = 21) atrium of 14 animals, with no difference between groups. In all groups there was elevation of troponin and CRP 24 h after ablation, with a return to baseline values after 14 days. However, CRP levels of the control, corticoid, and sham groups were similar at all three time points analysed (baseline P = 0.52, 24 h P = 0.21, 14 days P = 0.66). Histological analysis did not show any difference between corticoid and control groups.
  
  
  CONCLUSIONS
  In this model, extensive biatrial RF ablation, per se, does not promote systemic inflammation. The use of a prophylactic single corticoid dose before ablation did not prevent systemic inflammation or alter the healing of the lesions.
authors.affiliation: Discipline of Cardiology, Paulista School of Medicine, Federal University of São Paulo, Pedro de Toledo 781, 10th Floor (Cardiology), São Paulo, SP 04039-032, Brazil.
authors.forename: Thais
authors.initials: T
authors.lastname: Nascimento
authors.forename: Fernanda
authors.initials: F
authors.lastname: Mota
authors.forename: Luis Felipe
authors.initials: LF
authors.lastname: dos Santos
authors.forename: Sérgio
authors.initials: S
authors.lastname: de Araujo
authors.forename: Mieko
authors.initials: M
authors.lastname: Okada
authors.forename: Marcello
authors.initials: M
authors.lastname: Franco
authors.forename: Angelo
authors.initials: A
authors.lastname: de Paola
authors.forename: Guilherme
authors.initials: G
authors.lastname: Fenelon
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery; D002097:C-Reactive Protein / Q000032:analysis; D017115:Catheter Ablation / Q000009:adverse effects*; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D006325:Heart Atria / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007249:Inflammation / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D013552:Swine; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood
chemical_list: D000893:Anti-Inflammatory Agents; D014336:Troponin; D002097:C-Reactive Protein; D008775:Methylprednisolone