Serum sRANKL/OPG predict recurrence after radiofrequency catheter ablation of lone atrial fibrillation

Background: Radiofrequency catheter ablation (RFCA) is a widely accepted strategy for eliminating atrial fibrillation (AF). A considerable recurrence rate has partly been ascribed to atrial remodeling. Osteoprotegerin (OPG)/receptor activator of nuclear factor-kappa B (RANK)/RANK ligand (RANKL) axis may contribute to the development and progression of AF by regulating atrial structural remodeling. This study aimed to determine the relationship between serum soluble RANKL (sRANKL)/OPG and the risk of recurrent arrhythmia after ablation of lone AF. Methods: We enrolled 527 lone AF patients undergoing first-time RFCA with complete follow-up data. Preablation venous blood samples were obtained for measurement of serum sRANKL and OPG. Results: During the follow-up period of 15 (3-64) months, AF recurred in 187 patients (35.5%). Recurrence was associated with an elevation of serum sRANKL level and sRANKL/OPG ratio. In multivariate survival regression, persistent AF, AF duration, left atrial diameter, amiodarone after ablation, particularly serum sRANKL level and sRANKL/OPG ratio independently predicted AF recurrence. According to ROC curve analysis, the best diagnostic values of serum sRANKL level and sRANKL/OPG ratio for predicting recurrence were 4.89 pmol/l and 0.76, respectively. Conclusions: Baseline serumhigh sRANKL level and sRANKL/OPG ratio are associated with AF recurrence after primary ablation procedure in lone AF patients, andmay be used in the prediction of AF recurrence in these patients. (C) 2013 Elsevier Ireland Ltd. All rights reserved.