BACKGROUND: Plasma B-type natriuretic peptide (BNP) is abnormally elevated in patients with lone atrial fibrillation (AF). The exact significance and prognostic implications of this elevation have yet to be determined. Little is known about BNP in lone AF patients undergoing arrhythmia ablation. We sought to determine the relationship between BNP levels and the risk of recurrent arrhythmia after ablation of lone AF. METHODS AND RESULTS: We followed up 726 patients with lone AF undergoing first-time arrhythmia ablation. All had BNP levels measured on the day of ablation with of the point-of-care Triage Meter assay (Biosite Diagnostics, San Diego, CA). At baseline, factors associated with elevated BNP levels in multivariable linear regression analysis (with log BNP being the dependent variable) were older age (β regression coefficient for +1-year change, 0.025; P<0.0001), longer duration of AF (β for +1-year change, 0.031; P=0.01), nonparoxysmal AF (versus paroxysmal; β, 0.52; P<0.0001), and larger left atrial size (β for +1-cm(2) change, 0.040; P<0.0001). The BNP levels were strongly associated with arrhythmia recurrence in univariate- (hazard ratio for +1-log-BNP change, 2.32; 95% confidence interval, 2.11 to 2.74; P<0.001) and covariate- (hazard ratio for +1-log-BNP change, 2.13; 95% confidence interval, 2.06 to 2.38; P<0.001) adjusted Cox proportional hazards analysis. The covariate-adjusted hazard ratios for recurrent arrhythmia were 1.6, 2.7, 4.3, and 5.7 for the second, third, fourth, and fifth quintiles, respectively, compared with patients in the lowest quintile (P for trend across quintiles <0.001). CONCLUSIONS: B-type natriuretic peptide levels correlate with AF burden (chronicity, altered hemodynamics, and anatomic remodeling) in patients with lone AF and are strong predictors of recurrent arrhythmia after ablation. Elevated BNP levels may reflect increased cardiac chamber wall stress and/or intrinsic atrial disease, thus increasing the risk of arrhythmia recurrence.
BACKGROUND: Plasma B-type natriuretic peptide (BNP) is abnormally elevated in patients with lone atrial fibrillation (AF). The exact significance and prognostic implications of this elevation have yet to be determined. Little is known about BNP in lone AFpatients undergoing arrhythmia ablation. We sought to determine the relationship between BNP levels and the risk of recurrent arrhythmia after ablation of lone AF. METHODS AND RESULTS: We followed up 726 patients with lone AF undergoing first-time arrhythmia ablation. All had BNP levels measured on the day of ablation with of the point-of-care Triage Meter assay (Biosite Diagnostics, San Diego, CA). At baseline, factors associated with elevated BNP levels in multivariable linear regression analysis (with log BNP being the dependent variable) were older age (β regression coefficient for +1-year change, 0.025; P<0.0001), longer duration of AF (β for +1-year change, 0.031; P=0.01), nonparoxysmal AF (versus paroxysmal; β, 0.52; P<0.0001), and larger left atrial size (β for +1-cm(2) change, 0.040; P<0.0001). The BNP levels were strongly associated with arrhythmia recurrence in univariate- (hazard ratio for +1-log-BNP change, 2.32; 95% confidence interval, 2.11 to 2.74; P<0.001) and covariate- (hazard ratio for +1-log-BNP change, 2.13; 95% confidence interval, 2.06 to 2.38; P<0.001) adjusted Cox proportional hazards analysis. The covariate-adjusted hazard ratios for recurrent arrhythmia were 1.6, 2.7, 4.3, and 5.7 for the second, third, fourth, and fifth quintiles, respectively, compared with patients in the lowest quintile (P for trend across quintiles <0.001). CONCLUSIONS:B-type natriuretic peptide levels correlate with AF burden (chronicity, altered hemodynamics, and anatomic remodeling) in patients with lone AF and are strong predictors of recurrent arrhythmia after ablation. Elevated BNP levels may reflect increased cardiac chamber wall stress and/or intrinsic atrial disease, thus increasing the risk of arrhythmia recurrence.
Authors: E Santamarina; A Penalba; T García-Berrocoso; P Delgado; M Quintana; T González-Alujas; M Ribó; O Maisterra; C A Molina; A Evangelista; J Alvarez-Sabín; J Montaner Journal: J Neurol Date: 2012-05-17 Impact factor: 4.849
Authors: John H Rosenberg; John H Werner; Gilman D Plitt; Victoria V Noble; Jordan T Spring; Brooke A Stephens; Aleem Siddique; Helenmari L Merritt-Genore; Michael J Moulton; Devendra K Agrawal Journal: Expert Rev Cardiovasc Ther Date: 2018-12-29
Authors: Paul Erne; Therese J Resink; Andrea Mueller; Michael Coslovsky; Richard Kobza; David Conen; Peter Bauer; Patricia Arand Journal: J Atr Fibrillation Date: 2017-06-30
Authors: Amir Y Shaikh; Nada Esa; William Martin-Doyle; Menhel Kinno; Iryna Nieto; Kevin C Floyd; Clifford Browning; Cynthia Ennis; J Kevin Donahue; Lawrence S Rosenthal; David D McManus Journal: Crit Pathw Cardiol Date: 2015-12