Key result
Low baseline BNP concentration (<38.3 pg/mL) was independently associated with a lower risk of recurrent atrial tachyarrhythmias (HR 0.63) compared to higher BNP concentrations after atrial fibrillation ablation.
Why the study?
The prognostic importance of B-type natriuretic peptide concentrations for clinical events following catheter ablation for atrial fibrillation was evaluated.
Does low baseline BNP concentration predict lower rates of recurrent tachyarrhythmias and heart failure in patients undergoing initial catheter ablation for atrial fibrillation?
Observational (n=1,750)
Yes
Does low baseline BNP concentration predict lower rates of recurrent tachyarrhythmias and heart failure in patients undergoing initial catheter ablation for atrial fibrillation?
Low baseline BNP (<38.3 pg/mL) is a strong independent predictor of freedom from arrhythmia recurrence and heart failure events after initial catheter ablation for atrial fibrillation.
Answers are grounded in this paper and cite their sources.
May guide post-AF ablation monitoring intensity; hypothesis-generating and should not yet change practice.
BACKGROUND: This study assessed the prognostic importance of B-type natriuretic peptide (BNP) concentrations for clinical events after catheter ablation for atrial fibrillation (AF). METHODS AND RESULTS: We enrolled 1,750 consecutive patients undergoing initial AF ablation whose baseline BNP data were available from a large-scale multicenter observational cohort (TRANQUILIZE-AF Registry). The prognostic impact of BNP concentration on clinical outcomes, including recurrent tachyarrhythmias and a composite of heart failure (HF) hospitalization or cardiac death, was evaluated. Median baseline BNP was 94.2 pg/mL. During a median follow-up of 2.4 years, low BNP (<38.3 pg/mL) was associated with lower rates of recurrent atrial tachyarrhythmias than BNP concentrations ≥38.3 pg/mL (19.9% vs. 30.6% at 3 years; P<0.001) and HF (0.8% vs. 5.3% at 3 years; P<0.001). Multivariable Cox regression analyses revealed that low BNP was independently associated with lower risks of arrhythmia recurrence (hazard ratio [HR] 0.63; 95% confidence interval [CI] 0.47-0.82; P<0.001) and HF (HR 0.17; 95% CI 0.04-0.71; P=0.002). The favorable impact of low BNP on arrhythmia recurrence was prominent in patients with paroxysmal, but not non-paroxysmal, AF, particularly among those with long-standing AF. CONCLUSIONS: Low BNP concentrations had a favorable impact on clinical outcomes after AF ablation. The heterogeneous impact of baseline BNP concentrations on arrhythmia recurrence for the subgroups of patients divided by AF type warrants future larger studies with longer follow-up periods.
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Kawaji et al. (2023) conducted an observational in Atrial Fibrillation (n=1,750). Low baseline BNP concentration (<38.3 pg/mL) vs. High baseline BNP concentration (≥38.3 pg/mL) was evaluated on Recurrent atrial tachyarrhythmias after the procedure (HR 0.63, 95% CI 0.47-0.82, p=<0.001). Low baseline BNP concentration (<38.3 pg/mL) was independently associated with a lower risk of recurrent atrial tachyarrhythmias (HR 0.63) compared to higher BNP concentrations after atrial fibrillation ablation.
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