Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation

Michela Casella, Antonio Dello Russo, Eleonora Russo, Ghaliah Al-Mohani, Pasquale Santangeli, Stefania Riva, Gaetano Fassini, Massimo Moltrasio, Ester Innocenti, Daniele Colombo, Fabrizio Bologna, Gennaro Izzo, G. Joseph, Luigi Di Biase, Andrea Natale, Claudio Tondo

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Background: Our study aims to compare acute myocardial injury biomarker rise after atrial fibrillation ablation performed with different technologies.

Methods and Results: One hundred and ten patients were treated with pulmonary vein isolation with 4 different technologies: open-irrigated tip radiofrequency (RF) catheter in 35 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.

Original languageEnglish (US)
Pages (from-to)516-523
Number of pages8
JournalCardiology Journal
Issue number5
StatePublished - 2014
Externally publishedYes


  • Atrial fibrillation ablation
  • Cardiac biochemical markers
  • Cardiac troponin I
  • Creatinine kinase-MB
  • Myocardial injury

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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