Improved Endothelial Function in Patients with Atrial Fibrillation through Maintenance of Sinus Rhythm by Successful Catheter Ablation

Methods: This study prospectively enrolled 80 subjects who underwent CA for AF (paroxysmal AF = 61, persistent AF = 19). Eighty subjects with no history of AF were enrolled as controls, all of whom were matched by age, gender, body mass index, and atherosclerotic risk factor distribution. Brachial artery flow-mediated dilatation (FMD) was measured at baseline, and at 1 month and 6 months post CA in AF subjects who remained in SR. Among controls, FMD was measured at baseline and at 6 months. We used high sensitivity C-reactive protein (hs-CRP), interleukin-6, soluble E- or P-selectin, and endothelin-1 as biomarker indices for inflammation and/or ED. Results: Compared with controls, AF subjects had lower FMD at baseline (FMDbaseline, P < 0.001). After successful CA, FMD was significantly improved at 1 month and 6 months, nearly approaching control levels. A multivariate analysis revealed that FMDbaseline, hs-CRP, and left atrial volume (LAV) were independent predictors for arrhythmia recurrence after CA. Other biomarkers were not related to rhythm outcome. Conclusion: AF subjects have significantly impaired FMD, which can be reversed through maintenance of SR by successful CA. FMDbaseline, hs-CRP, and LAV are important predictors for AF recurrence after CA. (J Cardiovasc Electrophysiol, Vol. 22, pp. 376-382).