title: Cardiac Autoantibody Levels Predict Recurrence Following Cryoballoon-Based Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation Patients.
abstract: BACKGROUND
  Recent evidence has suggested that autoantibodies may play an important role in the development of atrial fibrillation (AF). The predictive value of preprocedural autoantibodies against beta-1 adrenergic receptor (anti-β1-R) and M2-muscarinic acetylcholine receptor (anti-M2-R) for AF recurrence following cryoballoon-based pulmonary vein isolation (PVI) is still unclear. We aimed to determine the predictive value of preprocedural anti-β1-R and anti-M2-R levels for AF recurrence.
  
  
  METHODS
  Eighty patients (mean age 54.25 ± 7.70 years; 40% female) with paroxysmal AF and preserved left ventricular function who underwent cryoballoon-based PVI were included in the study. Preprocedural anti-M2-R and anti-β1-R levels were measured with ELISA.
  
  
  RESULTS
  At 1-year follow-up after ablation, late AF recurrence was observed in 17 (21.25%) patients. In the Cox regression model, including number of antiarrhythmic drugs, early AF recurrence, anti-β1-R levels >159.88 ng/mL, anti-M2-R levels >277.65 ng/mL, AF duration, and left atrial volume index, only anti-β1-R levels >159.88 ng/mL (HR: 4.281, P = 0.039) and anti-M2-R levels >277.65 ng/mL (HR: 4.313, P = 0.030) were found to be independent predictors of late AF recurrence. Anti-β1-R level >159.88 ng/mL was shown to predict late AF recurrence with a sensitivity of 70.59% and specificity of 90.48%. A cut-off value of 277.65 ng/mL for anti-M2-R level predicted AF recurrence with a sensitivity of 70.59% and specificity of 95.24%.
  
  
  CONCLUSIONS
  Preprocedural serum anti-β1-R and anti-M2-R levels are independent predictors of late AF recurrence following cryoballoon-based PVI in paroxysmal AF patients. Detection of preprocedural anti-β1-R and anti-M2-R levels may serve as a novel method for determination of paroxysmal AF patients who may not benefit from cryoballoon-based PVI.
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Muhammed Ulvi
authors: MU
authors: Yalcin
authors: Department of Cardiology, Kars Harakani State Hospital, Kars, Turkey.
authors: Kadri Murat
authors: KM
authors: Gurses
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Duygu
authors: D
authors: Kocyigit
authors: Department of Basic Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
authors: Sacit Altug
authors: SA
authors: Kesikli
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Muhammet
authors: M
authors: Dural
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Banu
authors: B
authors: Evranos
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Hikmet
authors: H
authors: Yorgun
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Levent
authors: L
authors: Sahiner
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Ergun Baris
authors: EB
authors: Kaya
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Mehmet Ali
authors: MA
authors: Oto
authors: Department of Basic Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
authors: Dicle
authors: D
authors: Guc
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Kudret
authors: K
authors: Aytemir
authors: Department of Cardiology, Hacettepe University Faculty of Medicine, Kars, Turkey.
authors: Necla
authors: N
authors: Ozer
mesh_terms: D001281:Atrial Fibrillation / Q000276:immunology* / Q000601:surgery*; D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000276:immunology*; D006328:Cardiac Catheterization / Q000379:methods; D003452:Cryosurgery / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011667:Pulmonary Veins / Q000601:surgery*; D043585:Receptor, Muscarinic M2 / Q000276:immunology*; D018342:Receptors, Adrenergic, beta-1 / Q000276:immunology*; D012008:Recurrence
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D043585:Receptor, Muscarinic M2; D018342:Receptors, Adrenergic, beta-1
keywords: atrial fibrillation; cardiac autoantibodies; catheter ablation; cryoballoon; recurrence, pulmonary vein isolation