TY - JOUR
T1 - Elevated brain natriuretic peptide level in patients undergoing atrial fibrillation ablation
T2 - Is it a predictor of failed ablation or a mere function of atrial rhythm and rate at a point in time?
AU - Pillarisetti, Jayasree
AU - Reddy, Namratha
AU - Biria, Mazda
AU - Ryschon, Kay
AU - Nagarajan, Darbhamulla
AU - Murray, Caroline
AU - Atkins, Donita
AU - Bommana, Sudharani
AU - Reddy, Madhu Yeruva
AU - DiBiase, Luigi
AU - Pimentel, Rhea
AU - Berenbom, Loren
AU - Dawn, Buddhadeb
AU - Natale, Andrea
AU - Lakkireddy, Dhanunjaya
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/8
Y1 - 2014/8
N2 - Background: Pre- and postablation atrial fibrillation (AF) brain natriuretic peptide (BNP) levels were shown to predict increased recurrence of AF following ablation. Objective: Our objective was to assess whether elevated BNP levels merely represent the presence of AF at the time of measurement or indeed the true recurrence of AF. Methods and Results: In a prospective study of 88 patients undergoing AF ablation, BNP levels were measured immediately before, after, 24 h, and 4-6 months postablation. BNP levels were stratified by presenting rhythm and ventricular rate at the time of measurement. Median BNP level preablation was higher in patients presenting in AF compared to sinus rhythm (SR) (54(44-79)pg/ml vs. 30(18-47)pg/ml, p<0.001). Postablation restoration of SR in patients presenting in AF reduced median BNP levels from 54(44-79)pg/ml to 40(37-51)pg/ml, (p<0.001). However, no change was noted in patients who presented in and maintained SR throughout the procedure (30(18-47)pg/ml to 27(16-40)pg/ml, p=0.270). At 4-6 months, BNP measured in patients in SR was not significantly different from postablation BNP (35(22-53)pg/ml vs. 38(20-52)pg/ml, p=0.656), although 35 % of them had AF recurrence in 1-year follow-up. Median BNP level measured in five patients while in atrial arrhythmia was elevated compared to postablation BNP (464(421-464)pg/ml to 37(36-37)pg/ml, p=0.043). BNP levels and ventricular rates are positively correlated at all times pre- and postablation. Conclusions: BNP level rises acutely during AF and with rapid ventricular rates. BNP level seems to be a function of atrial rhythm and ventricular rate rather than short- or long-term predictor of AF ablation success.
AB - Background: Pre- and postablation atrial fibrillation (AF) brain natriuretic peptide (BNP) levels were shown to predict increased recurrence of AF following ablation. Objective: Our objective was to assess whether elevated BNP levels merely represent the presence of AF at the time of measurement or indeed the true recurrence of AF. Methods and Results: In a prospective study of 88 patients undergoing AF ablation, BNP levels were measured immediately before, after, 24 h, and 4-6 months postablation. BNP levels were stratified by presenting rhythm and ventricular rate at the time of measurement. Median BNP level preablation was higher in patients presenting in AF compared to sinus rhythm (SR) (54(44-79)pg/ml vs. 30(18-47)pg/ml, p<0.001). Postablation restoration of SR in patients presenting in AF reduced median BNP levels from 54(44-79)pg/ml to 40(37-51)pg/ml, (p<0.001). However, no change was noted in patients who presented in and maintained SR throughout the procedure (30(18-47)pg/ml to 27(16-40)pg/ml, p=0.270). At 4-6 months, BNP measured in patients in SR was not significantly different from postablation BNP (35(22-53)pg/ml vs. 38(20-52)pg/ml, p=0.656), although 35 % of them had AF recurrence in 1-year follow-up. Median BNP level measured in five patients while in atrial arrhythmia was elevated compared to postablation BNP (464(421-464)pg/ml to 37(36-37)pg/ml, p=0.043). BNP levels and ventricular rates are positively correlated at all times pre- and postablation. Conclusions: BNP level rises acutely during AF and with rapid ventricular rates. BNP level seems to be a function of atrial rhythm and ventricular rate rather than short- or long-term predictor of AF ablation success.
KW - Brain natriuretic peptide (BNP)
KW - Catheter ablation and atrial fibrillation
KW - Rhythm
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U2 - 10.1007/s10840-014-9898-7
DO - 10.1007/s10840-014-9898-7
M3 - Article
C2 - 24800931
AN - SCOPUS:84905578132
SN - 1383-875X
VL - 40
SP - 161
EP - 168
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
IS - 2
ER -