Time course of inflammation, myocardial injury, and prothrombotic response after radiofrequency catheter ablation for atrial fibrillation.
BACKGROUND
Inflammation has been linked to the genesis of stroke in atrial fibrillation (AF) and is implicated in early recurrent arrhythmia after AF ablation. We aimed to define the time course of inflammation, myocardial injury, and prothrombotic markers after radiofrequency ablation for AF and its relation to AF recurrence.


RESULTS
Ninety consecutive AF patients (53% paroxysmal) undergoing radiofrequency ablation were recruited. High-sensitivity C-reactive protein (hs-CRP), Troponin-T, creatine kinase-MB, fibrinogen, and D-Dimer concentrations were measured at baseline, at 1, 2, 3, 7 days, and at 1 month after ablation. AF recurrence was documented at 3 days and at 1, 3, and 6 months follow-up. Troponin-T and creatine kinase-MB peaked at day 1 after procedure (both P<0.05). Hs-CRP peaked at day 3 after procedure (P<0.05). Fibrinogen (P<0.05) and D-Dimer (P<0.05) concentrations were significantly elevated at 1 week after procedure. Ln hs-CRP elevation correlated with Ln Troponin-T and fibrinogen elevation. The extent of Ln hs-CRP, Ln Troponin-T, and fibrinogen elevation predicted early AF recurrence within 3 days after procedure (P<0.05, respectively), but not at 3 and 6 months.


CONCLUSIONS
Patients undergoing radiofrequency ablation for AF exhibit an inflammatory response within 3 days. The extent of inflammatory response predicts early AF recurrence but not late recurrence. Prothrombotic markers are elevated at 1 week after ablation and may contribute to increased risk of early thrombotic events after AF ablation.
Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide & Royal Adelaide Hospital, Adelaide, Australia.
Han S
HS
Lim
Carlee
C
Schultz
Jerry
J
Dang
Muayad
M
Alasady
Dennis H
DH
Lau
Anthony G
AG
Brooks
Christopher X
CX
Wong
Kurt C
KC
Roberts-Thomson
Glenn D
GD
Young
Matthew I
MI
Worthley
Prashanthan
P
Sanders
Scott R
SR
Willoughby
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D017115:Catheter Ablation / Q000009:adverse effects*; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006335:Heart Injuries / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D018836:Inflammation Mediators; D020107:Troponin T; C036309:fibrin fragment D; D005340:Fibrinogen; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form
atrial fibrillation; catheter ablation; inflammation; thrombosis