High-sensitive cardiac troponin T release after pulmonary vein isolation was not predictive of atrial fibrillation recurrence but significantly predicted symptomatic pericarditis (OR 1.003; P=0.015).
Observational (n=96)
Do myocardial injury markers (hs-cTnT and CK-MB) predict atrial fibrillation recurrence or complications after pulmonary vein isolation?
Post-ablation hs-cTnT elevation predicts symptomatic pericarditis but not atrial fibrillation recurrence after pulmonary vein isolation.
Effect estimate: OR 1.003 (95% CI 1.001 to 1.005)
p-value: p=0.015
Introduction: Myocardial injury markers such as high-sensitive cardiac troponin T (hs-cTnT) and creatine kinase MB (CK-MB) reflects the amount of myocardial injury with ablation. The aim of the study was to identify the value of myocardial injury markers to predict outcomes after pulmonary vein isolation (PVI) using three different ablation technologies. Methods: Consecutive patients undergoing PVI using a standard 3.5 mm irrigated-tip radiofrequency catheter (RF-group), an irrigated multielectrode radiofrequency catheter (IMEA-group) and a second-generation cryoballoon (CB-group) were analysed. Blood samples to measure injury markers were taken before and 18-24 hours after the ablation. Procedural complications were collected and standardised follow-up was performed. Logistic regression was used to identify predictors of recurrence and complications. Results: 96 patients (RF group: n=40, IMEA-group: n=17, CB-group: n=39) undergoing PVI only were analysed (82% male, age 59±10 years). After a follow-up of 12 months, atrial fibrillation (AF) recurred in 45% in the RF-group, 29% in the IMEA-group and 36% in the CB-group (p=0.492). Symptomatic pericarditis was observed in 20% of patients in the RF-group, 15% in the IMEA-group and 5% in the CB-group (p=0.131). None of the injury markers was predictive of AF recurrence or PV reconnection after a single procedure. However, hs-cTnT was identified as a predictor of symptomatic pericarditis (OR: 1.003 1.001 to 1.005, p=0.015). Conclusion: Hs-cTnT and CK-MB were significantly elevated after PVI, irrespective of the ablation technology used. None of the myocardial injury markers were predictive for AF recurrence or PV reconnection, but hs-cTnT release predicts the occurrence of symptomatic pericarditis after PVI.
Zeljković et al. (Mon,) conducted a observational in Atrial fibrillation (n=96). High-sensitive cardiac troponin T (hs-cTnT) was evaluated on Symptomatic pericarditis (OR 1.003, 95% CI 1.001 to 1.005, p=0.015). High-sensitive cardiac troponin T release after pulmonary vein isolation was not predictive of atrial fibrillation recurrence but significantly predicted symptomatic pericarditis (OR 1.003; P=0.015).