Journal
PLOS ONE
Volume 13, Issue 1, Pages -Publisher
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0189936
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Funding
- British Heart Foundation fellowships [FS/1062/28409]
- German Research Foundation [D0637/14-1]
- National Institute for Health Research Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust and King's College London
- Leeds General Infirmary cardiac electrophysiology research fund
- National Institute for Health Research, Leeds Cardiovascular Clinical Research Facility
- Gordon Begg's research fellowship
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Aims & para;& para;To test the ability of four circulating biomarkers of fibrosis, and of low left atrial voltage, to predict recurrence of atrial fibrillation after catheter ablation.& para;& para;Background & para;& para;Circulating biomarkers potentially may be used to improve patient selection for atrial fibrillation ablation. Low voltage areas in the left atrium predict arrhythmia recurrence when mapped in sinus rhythm. This study tested type III procollagen N terminal peptide (PIIINP), galectin-3 (gal-3), fibroblast growth factor 23 (FGF-23), and type I collagen C terminal telopeptide (ICTP), and whether low voltage areas in the left atrium predicted atrial fibrillation recurrence, irrespective of the rhythm during mapping.& para;& para;Methods & para;& para;92 atrial fibrillation ablation patients were studied. Biomarker levels in peripheral and intracardiac blood were measured with enzyme-linked immunosorbent assay. Low voltage (<0.5mV) was expressed as a proportion of the mapped left atrial surface area. Follow-up was one year. The primary endpoint was recurrence of arrhythmia. The secondary endpoint was a composite of recurrence despite two procedures, or after one procedure if no second procedure was undertaken.& para;& para;Results & para;& para;The biomarkers were not predictive of either endpoint. After multivariate Cox regression analysis, high proportion of low voltage area in the left atrium was found to predict the primary endpoint in sinus rhythm mapping (hazard ratio 4.323, 95% confidence interval 1.33713.982, p = 0.014) and atrial fibrillation mapping (hazard ratio 5.195, 95% confidence interval 1.032-26.141, p = 0.046). This effect was also apparent for the secondary endpoint.& para;& para;Conclusion & para;& para;The studied biomarkers do not predict arrhythmia recurrence after catheter ablation. Left atrial voltage is an independent predictor of recurrence, whether the left atrium is mapped in atrial fibrillation or sinus rhythm.
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