Background: Our study aims to compare acute myocardial injury biomarker rise after atrial fibrillation ablation performed with different technologies.Methods and Results: One hundred and ten patients were treated with pulmonary vein isolation with 4 different technologies: open-irrigated tip radiofrequency (RF) catheter in 35 patients (Group A), cryoballoon in 35 patients (Group B), visually guided laser balloon in 20 patients (Group C), open-irrigated tip RF catheter with contact-force-sensing technology in 20 patients (Group D). Post-procedure samples of cardiac troponin I (cTnI) and creatinine kinase-MB (CK-MB) were collected at 19 ± 3 h and 43 ± 3 h after ablation. At the first postprocedural sample, cTnI and CK-MB levels were found elevated in all 110 patients with a median value of 2.11 ng/mL and 8.95 ng/mL, respectively. Group B showed cTnI levels increased (median 5.96 ng/mL) compared to other groups (median Group A: 1.72 ng/mL, Group C: 1.54 ng/mL, Group D: 2.0 ng/mL; p < 0.001). Also CK-MB levels resulted higher in cryoablation (median 26.4 ng/mL) compared to other groups (median Group A: 6.40 ng/mL, Group C: 7.15 ng/mL, Group D: 6.50 ng/mL; p < 0.001). No significant association was observed between biomarker levels and recurrences of atrial fibrillation after a mean follow-up of 369 ± 196 days.Conclusions: Highest markers for myocardial injury were observed in the cryoballoon group. It is possible that a longer delivery energy duration and other factors affecting lesion size resulted in higher amount of cardiac injury in cryoablation. The higher levels of cardiac biomarkers did not translate into a better outcome and its physiologic significance is unknown.

Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation / M. Casella, A.D. Russo, E. Russo, G. Al-Mohani, P. Santangeli, S. Riva, G. Fassini, M. Moltrasio, E. Innocenti, D. Colombo, F. Bologna, G. Izzo, G. Joseph, L.D. Biase, A. Natale, C. Tondo. - In: CARDIOLOGY JOURNAL. - ISSN 1897-5593. - 21:5(2014), pp. 516-523. [10.5603/CJ.a2013.0153]

Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation

E. Innocenti;D. Colombo;A. Natale;C. Tondo
2014

Abstract

Background: Our study aims to compare acute myocardial injury biomarker rise after atrial fibrillation ablation performed with different technologies.Methods and Results: One hundred and ten patients were treated with pulmonary vein isolation with 4 different technologies: open-irrigated tip radiofrequency (RF) catheter in 35 patients (Group A), cryoballoon in 35 patients (Group B), visually guided laser balloon in 20 patients (Group C), open-irrigated tip RF catheter with contact-force-sensing technology in 20 patients (Group D). Post-procedure samples of cardiac troponin I (cTnI) and creatinine kinase-MB (CK-MB) were collected at 19 ± 3 h and 43 ± 3 h after ablation. At the first postprocedural sample, cTnI and CK-MB levels were found elevated in all 110 patients with a median value of 2.11 ng/mL and 8.95 ng/mL, respectively. Group B showed cTnI levels increased (median 5.96 ng/mL) compared to other groups (median Group A: 1.72 ng/mL, Group C: 1.54 ng/mL, Group D: 2.0 ng/mL; p < 0.001). Also CK-MB levels resulted higher in cryoablation (median 26.4 ng/mL) compared to other groups (median Group A: 6.40 ng/mL, Group C: 7.15 ng/mL, Group D: 6.50 ng/mL; p < 0.001). No significant association was observed between biomarker levels and recurrences of atrial fibrillation after a mean follow-up of 369 ± 196 days.Conclusions: Highest markers for myocardial injury were observed in the cryoballoon group. It is possible that a longer delivery energy duration and other factors affecting lesion size resulted in higher amount of cardiac injury in cryoablation. The higher levels of cardiac biomarkers did not translate into a better outcome and its physiologic significance is unknown.
Atrial fibrillation ablation; Cardiac biochemical markers; Cardiac troponin I; Creatinine kinase-MB; Myocardial injury; Atrial Fibrillation; Biomarkers; Catheter Ablation; Creatine Kinase, MB Form; Cryosurgery; Echocardiography; Female; Follow-Up Studies; Humans; Male; Middle Aged; Myocardial Ischemia; Postoperative Complications; Prospective Studies; Pulmonary Veins; Severity of Illness Index; Troponin I; Troponin T; Cardiology and Cardiovascular Medicine
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
2014
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/540121
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