title: N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation.
abstract: OBJECTIVE
  We investigated the relationship between arrhythmia burden, left atrial volume (LAV) and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) at baseline and after long-term follow-up of atrial fibrillation (AF) ablation.
  
  
  METHODS
  We studied 38 patients (23 paroxysmal, 6 women, mean age 56 ± 11) scheduled for AF ablation. LAV was calculated on the basis of computed tomography images at baseline and long-term follow-up, and arrhythmia burden was graded from self-reported frequency and duration of AF episodes.
  
  
  RESULTS
  After a mean period of 22 ± 5 months, 28/38 patients (11/15 persistent) were free from AF recurrence. At baseline there were no differences in mean LAV (125 vs. 130 cm(3), p = 0.7) or median NT-pro-BNP (33.5 vs. 29.5 pmol/L, p = 0.9) between patients whose ablation had been successful or otherwise. At long-term follow-up, there was a marked decrease in LAV (105 vs. 134 cm(3), p < 0.05) and level of NT-pro-BNP (7 vs. 17.5 pmol/L, p < 0.05) in the successful ablation patients. NT-pro-BNP correlated with LAV both at baseline (r = 0.71, p < 0.001) and at follow-up (r = 0.57, p < 0.001). Arrhythmia burden correlated with both NT-pro-BNP (r = 0.47, p < 0.01) and LAV (r = 0.52, p < 0.01). A decrease in NT-pro-BNP at follow-up of >25% of baseline value had a specificity of 0.89 and a sensitivity of 0.6 (receiver operator characteristics, accuracy 0.82) for ablation success.
  
  
  CONCLUSIONS
  NT-pro-BNP correlates with LAV and arrhythmia burden in AF patients and both NT-pro-BNP and LAV decrease significantly after successful ablation. A decrease in NT-pro-BNP of >25% from the baseline value could be useful as a marker of ablation success.
authors: Institute of Medicine, University of Bergen, Bergen, Norway. eivind.solheim@helse-bergen.no
authors: Eivind
authors: E
authors: Solheim
authors: Morten Kristian
authors: MK
authors: Off
authors: Per Ivar
authors: PI
authors: Hoff
authors: Alessandro
authors: A
authors: De Bortoli
authors: Peter
authors: P
authors: Schuster
authors: Ole-Jørgen
authors: OJ
authors: Ohm
authors: Jian
authors: J
authors: Chen
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain