title: Markers of oxidative stress after ablation of atrial fibrillation are associated with inflammation, delivered radiofrequency energy and early recurrence of atrial fibrillation.
abstract: BACKGROUND
  The role of oxidative stress after radiofrequency ablation of atrial fibrillation (AF) has not yet been well characterized. We sought to evaluate the time course of biomarkers of oxidative stress and inflammation after AF ablation and their association with clinical variables.
  
  
  METHODS
  Thirty consecutive patients (57.9 ± 1.7 years, 63% males) with paroxysmal AF underwent pulmonary vein isolation and ablation of complex fractionated atrial electrograms. Biomarkers were determined in blood samples before ablation and 6 h, 1, 2, 7, 30, 90 and 180 days post-ablation.
  
  
  RESULTS
  The pro-oxidant enzyme myeloperoxidase and oxidized low-density lipoprotein reflecting oxidant damage of lipoproteins increased 2.9 ± 0.2-fold and 1.2 ± 0.1-fold, respectively, and were significantly up-regulated until day 2 post-ablation. The anti-oxidant enzyme copper/zinc superoxide dismutase did not change significantly. Inflammatory markers significantly increased (high-sensitivity C-reactive protein (hs-CRP): 41 ± 8-fold; interleukin-6: 4.4 ± 0.7-fold) for 7 and 2 days, respectively. The increase of myeloperoxidase and hs-CRP was interrelated and both predicted early recurrence of AF within the first post-ablation week (both p < 0.05). The increase of both markers was associated with the amount of delivered radiofrequency energy (p < 0.05). The up-regulation of hs-CRP correlated with troponin T (p = 0.008), while myeloperoxidase and troponin T were borderline associated (p = 0.054). However, the oxidative and inflammatory responses did not predict long-term ablation outcome (p > 0.05).
  
  
  CONCLUSIONS
  Markers of oxidative stress showed a significant up-regulation during the first 2 days after AF ablation. Their up-regulation was linked to inflammation, delivered radiofrequency energy, and early recurrence of AF, but did not predict long-term ablation outcome.
authors.affiliation: Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. bernhard.richter@meduniwien.ac.at
authors.forename: Bernhard
authors.initials: B
authors.lastname: Richter
authors.forename: Marianne
authors.initials: M
authors.lastname: Gwechenberger
authors.forename: Ariel
authors.initials: A
authors.lastname: Socas
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Zorn
authors.forename: Sulaima
authors.initials: S
authors.lastname: Albinni
authors.forename: Manfred
authors.initials: M
authors.lastname: Marx
authors.forename: Jutta
authors.initials: J
authors.lastname: Bergler-Klein
authors.forename: Thomas
authors.initials: T
authors.lastname: Binder
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.forename: Heinz D
authors.initials: HD
authors.lastname: Gössinger
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D015415:Biomarkers / Q000378:metabolism; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010865:Pilot Projects; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000601:surgery; D012008:Recurrence; D013997:Time Factors
chemical_list: D015415:Biomarkers
references.citation: Clin Res Cardiol. 2010 Dec;99(12):817-23
references.pmid: 20596713
references.citation: Pol Arch Med Wewn. 2009 Mar;119(3):115-21
references.pmid: 19514639
references.citation: Am Heart J. 2007 Jan;153(1):113-9
references.pmid: 17174648
references.citation: Burns. 2002 Sep;28(6):535-42
references.pmid: 12220910
references.citation: Heart Rhythm. 2011 Jul;8(7):994-1000
references.pmid: 21397045
references.citation: Antioxid Redox Signal. 2010 Oct 1;13(7):1033-49
references.pmid: 20380580
references.citation: Clin Chem. 1991 Mar;37(3):458-61
references.pmid: 2004457
references.citation: Clin Res Cardiol. 2007 Nov;96(11):833-49
references.pmid: 17955158
references.citation: Basic Res Cardiol. 2001 Sep;96(5):454-62
references.pmid: 11605992
references.citation: J Am Coll Cardiol. 2010 Feb 23;55(8):747-53
references.pmid: 20170812
references.citation: J Cardiovasc Electrophysiol. 2007 Sep;18(9):942-6
references.pmid: 17593228
references.citation: Heart Rhythm. 2007 Jun;4(6):816-61
references.pmid: 17556213
references.citation: Clin Res Cardiol. 2011 Apr;100(4):317-25
references.pmid: 20953959
references.citation: Med Hypotheses. 2009 Apr;72(4):466-7
references.pmid: 19103473
references.citation: Heart Rhythm. 2009 Jul;6(7):935-40
references.pmid: 19560081
references.citation: Free Radic Res. 2000 Aug;33(2):139-46
references.pmid: 10885621
references.citation: Burns. 2008 Feb;34(1):6-17
references.pmid: 17905515
references.citation: Tohoku J Exp Med. 2001 Jan;193(1):27-36
references.pmid: 11321048
references.citation: Pacing Clin Electrophysiol. 2008 Sep;31(9):1146-51
references.pmid: 18834466
references.citation: Arterioscler Thromb Vasc Biol. 2004 Jan;24(1):106-11
references.pmid: 14592844
references.citation: Burns. 2004 Mar;30(2):121-5
references.pmid: 15019118
references.citation: Can J Cardiol. 2000 Apr;16(4):505-11
references.pmid: 10787466
references.citation: Europace. 2008 Apr;10(4):444-9
references.pmid: 18339614
references.citation: N Engl J Med. 1999 Feb 11;340(6):448-54
references.pmid: 9971870
references.citation: Clin Chem. 2009 Aug;55(8):1462-70
references.pmid: 19556446
references.citation: Biochim Biophys Acta. 2002 Dec 30;1585(2-3):213-21
references.pmid: 12531556
references.citation: J Am Coll Cardiol. 2003 Feb 5;41(3):360-70
references.pmid: 12575961
references.citation: Clin Res Cardiol. 2008 May;97(5):298-305
references.pmid: 18491171
references.citation: J Am Coll Cardiol. 2010 Oct 26;56(18):1463-72
references.pmid: 20951321
references.citation: Burns. 2005 Nov;31(7):859-65
references.pmid: 15963644
references.citation: Zhonghua Yi Xue Za Zhi. 2004 Apr 2;84(7):548-53
references.pmid: 15144587
references.citation: Eur Heart J. 2006 Jan;27(2):136-49
references.pmid: 16278230
references.citation: Eur Heart J. 2009 May;30(10):1180-6
references.pmid: 19299430
references.citation: Angiology. 2006 May-Jun;57(3):283-93
references.pmid: 16703188
references.citation: Am J Cardiol. 2006 Dec 4;98(11A):9P-17P
references.pmid: 17126679
references.citation: Int J Cardiol. 2011 Oct 20;152(2):231-6
references.pmid: 20692054
references.citation: Europace. 2010 Feb;12(2):173-80
references.pmid: 19889688
references.citation: Clin Res Cardiol. 2010 Oct;99(10):651-6
references.pmid: 20473614
references.citation: J Exp Med. 2003 Mar 3;197(5):615-24
references.pmid: 12615902