Growth differentiation factor 15 level changes in the early and late periods after radiofrequency and pulsed field catheter ablation of atrial fibrillation

Introduction GDF-15 (growth differentiation factor 15) is a protein from the transforming growth factor β (TGF- β ) cytokine family. In patients with atrial fibrillation (AF), it is a potent marker of bleeding adverse events in anticoagulated patients and a predictor of overall mortality. However, its level is affected by various conditions, including radiofrequency catheter ablation (RFCA). The study aimed to describe the dynamics of GDF-15 following a novel AF treatment approach, pulsed field ablation (PFA). Methods This prospective observational study enrolled 50 patients [median (IQR) age 63 (53; 71) years, 62% males] undergoing PFA and compared them with 50 patients [65 (57; 69) years, 64% males] post-RFCA. Results In the PFA group, 30 (60%) patients had paroxysmal AF, compared with 20 (40%) patients in the RFCA group. The median (IQR) GDF-15 level at baseline was 943 (733; 1,148) ng/L. The median value recorded 24 h after PFA was 1,363 (901; 1,867) ng/L. No significant difference in values was observed between patients treated with RFCA and those treated with PFA. However, when comparing GDF-15 values in paroxysmal AF separately, significantly higher post-procedural GDF-15 levels (immediately post-ablation and in 24 h after procedure) were observed after PFA than RFCA: 963 (672; 1,266) vs. 630 (506; 804) ng/L with p < 0.001 and 1,363 (901; 1,960) vs. 843 (710; 1,195) ng/L, p < 0.01, respectively. No correlation was found between GDF-15 levels and procedural data. Conclusion GDF-15 levels are significantly affected by catheter ablation of AF, regardless of the ablation technology used.