title: Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation.
abstract: BACKGROUND
  Our study aims to compare acute myocardial injury biomarker rise after atrial fibrillation ablation performed with different technologies.
  
  
  RESULTS
  One hundred and ten patients were treated with pulmonary vein isolation with 4 different technologies: open-irrigated tip radiofrequency (RF) catheter in35 patients (Group A), cryoballoon in 35 patients (Group B), visually guided laser balloon in 20 patients (Group C), open-irrigated tip RF catheter with contact-force-sensing technology in 20 patients (Group D). Post-procedure samples of cardiac troponin I (cTnI) and creatinine kinase-MB (CK-MB) were collected at 19 ± 3 h and 43 ± 3 h after ablation. At the first postprocedural sample, cTnI and CK-MB levels were found elevated in all 110 patients with a median value of 2.11 ng/mL and 8.95 ng/mL, respectively. Group B showed cTnI levels increased (median 5.96 ng/mL) compared to other groups (median Group A: 1.72 ng/mL, Group C: 1.54 ng/mL, Group D: 2.0 ng/mL; p < 0.001). Also CK-MB levels resulted higher in cryoablation (median 26.4 ng/mL) compared to other groups (median Group A: 6.40 ng/mL, Group C: 7.15 ng/mL, Group D: 6.50 ng/mL; p < 0.001). No significant association was observed between biomarker levels and recurrences of atrial fibrillation after a mean follow-up of 369 ± 196 days.
  
  
  CONCLUSIONS
  Highest markers for myocardial injury were observed in the cryoballoon group. It is possible that a longer delivery energy duration and other factors affecting lesion size resulted in higher amount of cardiac injury in cryoablation. The higher levels of cardiac biomarkers did not translate into a better outcome and its physiologic significance is unknown.
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, Milan , Italy. elerusso81@hotmail.it.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Russo
authors.forename: Ghaliah
authors.initials: G
authors.lastname: Al-Mohani
authors.forename: Pasquale
authors.initials: P
authors.lastname: Santangeli
authors.forename: Stefania
authors.initials: S
authors.lastname: Riva
authors.forename: Gaetano
authors.initials: G
authors.lastname: Fassini
authors.forename: Massimo
authors.initials: M
authors.lastname: Moltrasio
authors.forename: Ester
authors.initials: E
authors.lastname: Innocenti
authors.forename: Daniele
authors.initials: D
authors.lastname: Colombo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bologna
authors.forename: Gennaro
authors.initials: G
authors.lastname: Izzo
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Gallinghouse
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
mesh_terms: D001281:Atrial Fibrillation / Q000097:blood / Q000601:surgery*; D015415:Biomarkers / Q000097:blood*; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D052279:Creatine Kinase, MB Form / Q000097:blood; D003452:Cryosurgery / Q000009:adverse effects* / Q000379:methods; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000601:surgery; D012720:Severity of Illness Index; D019210:Troponin I / Q000097:blood; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T; D052279:Creatine Kinase, MB Form