title: Serum sRANKL/OPG predict recurrence after radiofrequency catheter ablation of lone atrial fibrillation.
abstract: BACKGROUND
  Radiofrequency catheter ablation (RFCA) is a widely accepted strategy for eliminating atrial fibrillation (AF). A considerable recurrence rate has partly been ascribed to atrial remodeling. Osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/RANK ligand (RANKL) axis may contribute to the development and progression of AF by regulating atrial structural remodeling. This study aimed to determine the relationship between serum soluble RANKL (sRANKL)/OPG and the risk of recurrent arrhythmia after ablation of lone AF.
  
  
  METHODS
  We enrolled 527 lone AF patients undergoing first-time RFCA with complete follow-up data. Pre-ablation venous blood samples were obtained for measurement of serum sRANKL and OPG.
  
  
  RESULTS
  During the follow-up period of 15 (3-64)months, AF recurred in 187 patients (35.5%). Recurrence was associated with an elevation of serum sRANKL level and sRANKL/OPG ratio. In multivariate survival regression, persistent AF, AF duration, left atrial diameter, amiodarone after ablation, particularly serum sRANKL level and sRANKL/OPG ratio independently predicted AF recurrence. According to ROC curve analysis, the best diagnostic values of serum sRANKL level and sRANKL/OPG ratio for predicting recurrence were 4.89 pmol/l and 0.76, respectively.
  
  
  CONCLUSIONS
  Baseline serum high sRANKL level and sRANKL/OPG ratio are associated with AF recurrence after primary ablation procedure in lone AF patients, and may be used in the prediction of AF recurrence in these patients.
authors: Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors: Hailong
authors: H
authors: Cao
authors: Department of Cardiology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
authors: Ying
authors: Y
authors: Wu
authors: Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors: Qingguo
authors: Q
authors: Li
authors: Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors: Yanhu
authors: Y
authors: Wu
authors: Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors: Qing
authors: Q
authors: Zhou
authors: Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Department of Oncology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors: Oluf Dimitri
authors: OD
authors: Røe
authors: Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors: Yijiang
authors: Y
authors: Chen
authors: Department of Cardiology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China. Electronic address: ruxingw@sina.com.
authors: Ruxing
authors: R
authors: Wang
authors: Department of Thoracic and Cardiovascular Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. Electronic address: gldjw@163.com.
authors: Dongjin
authors: D
authors: Wang
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000097:blood / Q000401:mortality / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation / Q000009:adverse effects* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D057234:Preoperative Period; D053245:RANK Ligand / Q000097:blood*; D012008:Recurrence; D012307:Risk Factors; D012995:Solubility; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D053245:RANK Ligand; C505688:TNFSF11 protein, human
keywords: Lone atrial fibrillation; Osteoprotegerin; Radiofrequency catheter ablation; Recurrence; Soluble receptor activator of nuclear factor-κB ligand