Key result
Patients with ablation failure had significantly higher baseline NT-proBNP concentrations compared to those with successful ablation (22.0 vs 10.0 pmol/L; p=0.02).
Why the study?
Does baseline NT-proBNP predict ablation failure in patients with atrial fibrillation undergoing pulmonary vein isolation?
Cohort (n=51)
Does baseline NT-proBNP predict ablation failure in patients with atrial fibrillation undergoing pulmonary vein isolation?
p-value: p=0.02
Elevated baseline NT-proBNP (>15.0 pmol/L) independently predicts AF recurrence after catheter ablation, suggesting its potential utility in patient selection and risk stratification.
Higher baseline NT-proBNP was associated with ablation failure; hypothesis-generating for risk stratification and requires prospective validation.
AIMS: To investigate whether NT-proBNP before ablation treatment and after exercise testing has predictive information regarding the clinical outcome following pulmonary vein isolation in patients with atrial fibrillation (AF). METHODS: NT-proBNP analysis were obtained before the ablation (before and after exercise test), and repeated at 1, 3, and 12 months after the final procedure. RESULTS: A total of 51 patients were included. At study entry, the median NT-proBNP concentration was 14.0 pmol/L (quartiles: 8.0 and 27.0). After the exercise test, the mean NT-proBNP value increased from 13.0 pmol/L (quartiles: 7.5 and 26.0) to 15.0 pmol/L (quartiles: 9.0 and 34.0), p < 0.001. Following a maximum of two ablations, 22 patients were free of AF while 29 patients experienced recurrent AF. In patients with successful ablation, the mean NT-proBNP concentration at baseline was 10.0 pmol/L (quartiles: 7.0 and 22.2) compared to 22.0 pmol/L (quartiles: 12.0 and 34.5) in patients with ablation failure, p = 0.02. With respect to exercise testing, a trend towards a higher increases during exercise were seen in patients with recurrent AF compared to patients without: 2.0 pmol/L (quartiles 1.9 and 7.0) vs. 1.5 pmol/L (quartiles 0 and 3.0), p = 0.07. A baseline NT-proBNP concentration >15.0 pmol/L was found to be an independent predictor of ablation failure. CONCLUSION: A significantly lower NT-proBNP concentration at baseline and a trend towards a diminished increase during exercise was seen in patients successfully ablated for AF compared to patients with recurrent AF. A baseline NT-proBNP concentration
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Nilsson et al. (2009) conducted a cohort in Atrial fibrillation (n=51). Baseline NT-proBNP concentration was evaluated on Ablation failure (recurrent atrial fibrillation) (p=0.02). Patients with ablation failure had significantly higher baseline NT-proBNP concentrations compared to those with successful ablation (22.0 vs 10.0 pmol/L; p=0.02).
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