Radiofrequency catheter ablation significantly increased plasma markers of myocardial injury at 24 hours, including cTnI (0.92 vs 0.33 µg/L, p<0.001) and CK-MB (3.79 vs 1.85 µg/L, p<0.001).
Observational (n=32)
Does radiofrequency catheter ablation increase plasma markers of myocardial injury in patients undergoing ablation for AVNRT, AFL, and AF?
Radiofrequency catheter ablation induces detectable myocardial injury that correlates with ablation duration and is more pronounced in atrial fibrillation and flutter compared to AVNRT.
p-value: p=<0.001
BACKGROUND: In a prospective study, we measured plasma markers of myocardial damage induced by radiofrequency catheter ablation (RFA) with the protein biochip microarray system. METHODS: A total of 32 consecutive patients undergoing RFA for atrioventricular nodal re-entry tachycardia (AVNRT), right atrial flutter (AFL) and atrial fibrillation (AF) were included in the study. Cardiac troponin I (cTnI), creatine kinase isoenzyme MB (CK-MB), heart-type fatty acid binding protein (hFABP) and glycogen phosphorylase BB (GPBB) were measured using biochip array technology at baseline and 24 h after the procedure. RESULTS: Values for all markers increased 24 h after RFA (cTnI: 0.92+/-0.49 microg/L vs. 0.33+/-0.06 microg/L, p<0.001; CK-MB: 3.79+/-2.04 microg/L vs. 1.85+/-0.55 microg/L, p<0.001; hFABP: 2.82+/-0.95 microg/L vs. 2.00+/-0.95 microg/L, p<0.001; GPBB: 9.07+/-5.83 microg/L vs. 4.70+/-2.50 microg/L, p<0.001). The correlations between plasma marker levels and RFA time were cTnI: r=0.63, p<0.01; CK-MB: r=0.75, p<0.01; hFABP: r=0.55, p<0.05, GPBB: r=0.51, p<0.05; the correlation between RFA time and number of RF applications was significant (r=0.81, p<0.001). Patients with RFA due to AF or flutter had elevated cTnI, CK-MB and hFABP levels compared to patients with AVNRT (cTnI: 1.14+/- 0.49 microg/L vs. 0.59+/-0.25 microg/L, p<0.05; CK-MB: 4.46+/- 2.07 microg/L vs. 2.81+/-1.54 mug/L, p<0.05; hFABP: 3.21+/- 0.98 microg/L vs. 2.25+/-0.54 microg/L, p<0.01). CONCLUSIONS: Myocardial injury induced by RFA can be detected by cTnI, CK-MB, hFABP and GPBB. Plasma cTnI, CK-MB and hFABP levels significantly increased in patients with AFL and AF compared to patients with AVNRT. The increase of cTnI, CK-MB and GPBB levels correlates with the total duration of RFA.
Pudil et al. (Tue,) conducted a observational in Atrioventricular nodal re-entry tachycardia, right atrial flutter, and atrial fibrillation (n=32). Radiofrequency catheter ablation vs. Baseline was evaluated on Plasma markers of myocardial damage (cTnI, CK-MB, hFABP, GPBB) (p=<0.001). Radiofrequency catheter ablation significantly increased plasma markers of myocardial injury at 24 hours, including cTnI (0.92 vs 0.33 µg/L, p<0.001) and CK-MB (3.79 vs 1.85 µg/L, p<0.001).