Key result
Successful catheter ablation of atrial fibrillation in patients with LVEF ≤50% led to a greater relative reduction in BNP levels at 1 month compared to recurrence (56.5% vs -2.4%, P=0.027).
Why the study?
Does successful catheter ablation of atrial fibrillation reduce BNP levels in patients with left ventricular systolic dysfunction?
Cohort (n=54)
Does successful catheter ablation of atrial fibrillation reduce BNP levels in patients with left ventricular systolic dysfunction?
Absolute Event Rate: 56.5% vs -2.4%
p-value: p=0.027
Successful catheter ablation of atrial fibrillation in patients with left ventricular systolic dysfunction is associated with a significant reduction in BNP levels, which correlates with an increase in LVEF.
May indicate early response to successful AF ablation in LVEF ≤50%; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: Little is known about the association between B-type natriuretic peptide (BNP) levels and catheter ablation of atrial fibrillation (AF) in patients with heart failure. This study aimed to examine the impact of elimination of AF by catheter ablation on BNP levels in patients with left ventricular systolic dysfunction. METHODS: Fifty-four AF patients with left ventricular ejection fraction (LVEF) ≤ 50%, who underwent radiofrequency catheter ablation therapy of AF, were included. BNP sampling was performed at baseline, 3 days, and 1 month after ablation. RESULTS: After a follow-up period of 6 months, the BNP levels decreased significantly in the nonrecurrence group (n = 35; median 126.3 [interquartile 57.2-206.5] pg/mL, 63.5 [23.9-180.2] pg/mL, and 45.9 [21.9-160.3] pg/mL, P < 0.001, respectively), but not in the recurrence group (n = 19; 144.7 [87.1-217.3] pg/mL, 88.8 [12.9-213.2] pg/mL, and 118.5 [51.6-298.2] pg/mL, P = 0.368, respectively). The patients in the nonrecurrence group had a higher percentage relative reduction in BNP levels from baseline to 1 month after ablation than those in the recurrence group (56.5 [-9.0-77.4]% vs -2.4 [-47.1-60.9]%, P = 0.027). Additionally, a relative reduction in BNP levels significantly correlated with an increase in LVEF after ablation (r = 0.486, P < 0.001). CONCLUSIONS: Plasma BNP levels decreased significantly with successful catheter ablation of AF in patients with impaired LVEF. The decrease in BNP levels might be associated with early recovery of cardiac function and subsequent maintenance of sinus rhythm at follow-up.
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Yanagisawa et al. (2015) conducted a cohort in Atrial fibrillation with heart failure (n=54). Successful catheter ablation (nonrecurrence of atrial fibrillation) vs. Recurrence of atrial fibrillation was evaluated on Percentage relative reduction in BNP levels from baseline to 1 month after ablation (p=0.027). Successful catheter ablation of atrial fibrillation in patients with LVEF ≤50% led to a greater relative reduction in BNP levels at 1 month compared to recurrence (56.5% vs -2.4%, P=0.027).
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