BACKGROUND: Inflammatory markers (IM) are elevated in atrial fibrillation (AF). However the relation of IM to substrate modificationinAF remains unclear.We sought to assess the relationship of IM to fractio ated atrial electrogram (FAE) in patients undergoing AF ablation. METHODS: At baseline, left atrial (LA) pressure was recorded and peripheral blood was tested for IM. FAE mapping wasperformed before and after circumferential pulmonary vein and linear ablation (CPVA-L) and followed by FAEablation. Image processing was used to define the FAE areas. AF cycle-length (AFCL) was compared between baseline and after ablations from left atrial electrode. RESULTS: Older patients had higher cytokine levels. FAE area at baseline (secondary FAE) negatively correlated with the levels of interleukin-6 (IL-6, R2= -0.97 and p=0.03) and interleukin-12p70 (IL-12p70, R2= -0.97 and p=0.03). In addition, a significant reduction in FAE area and index occurred after CPVA-L (p=0.0001). FAE after CPVA-L (primary FAE) correlated with left atrial pressure (LAP), [R2 0.5, (p=0.02)]. The AFCL (in msec) increased from 135 ± 41 to 149.5+30 (p=ns) after CPVA-L and further increased to 191.5 ± 60 (p=0.007) after FAE ablation. CONCLUSIONS: There is a negative correlation of IL-6 and IL-12p70 to baseline FAE, suggesting a possibility of sequestration of these cytokines in left atrium. CPVA-L ablation reduces FAE area which when ablated increases AFCL, suggesting that these areas likely represent primary fragmentation due to rotors, triggered by atrial stretch as seen by the relation of left atrial pressure and post CPVA-L FAE.
BACKGROUND: Inflammatory markers (IM) are elevated in atrial fibrillation (AF). However the relation of IM to substrate modificationinAF remains unclear.We sought to assess the relationship of IM to fractio ated atrial electrogram (FAE) in patients undergoing AF ablation. METHODS: At baseline, left atrial (LA) pressure was recorded and peripheral blood was tested for IM. FAE mapping wasperformed before and after circumferential pulmonary vein and linear ablation (CPVA-L) and followed by FAEablation. Image processing was used to define the FAE areas. AF cycle-length (AFCL) was compared between baseline and after ablations from left atrial electrode. RESULTS: Older patients had higher cytokine levels. FAE area at baseline (secondary FAE) negatively correlated with the levels of interleukin-6 (IL-6, R2= -0.97 and p=0.03) and interleukin-12p70 (IL-12p70, R2= -0.97 and p=0.03). In addition, a significant reduction in FAE area and index occurred after CPVA-L (p=0.0001). FAE after CPVA-L (primary FAE) correlated with left atrial pressure (LAP), [R2 0.5, (p=0.02)]. The AFCL (in msec) increased from 135 ± 41 to 149.5+30 (p=ns) after CPVA-L and further increased to 191.5 ± 60 (p=0.007) after FAE ablation. CONCLUSIONS: There is a negative correlation of IL-6 and IL-12p70 to baseline FAE, suggesting a possibility of sequestration of these cytokines in left atrium. CPVA-L ablation reduces FAE area which when ablated increases AFCL, suggesting that these areas likely represent primary fragmentation due to rotors, triggered by atrial stretch as seen by the relation of left atrial pressure and post CPVA-L FAE.
Authors: Christian Jons; Uffe G Jacobsen; Rikke Moerch Joergensen; Niels Thue Olsen; Ulrik Dixen; Arne Johannessen; Heikki Huikuri; Marc Messier; Scott McNitt; Poul Erik Bloch Thomsen Journal: Heart Rhythm Date: 2010-11-18 Impact factor: 6.343
Authors: Hakan Oral; Carlo Pappone; Aman Chugh; Eric Good; Frank Bogun; Frank Pelosi; Eric R Bates; Michael H Lehmann; Gabriele Vicedomini; Giuseppe Augello; Eustachio Agricola; Simone Sala; Vincenzo Santinelli; Fred Morady Journal: N Engl J Med Date: 2006-03-02 Impact factor: 91.245
Authors: Sanjiv M Narayan; Matthew Wright; Nicolas Derval; Amir Jadidi; Andrei Forclaz; Isabelle Nault; Shinsuke Miyazaki; Frédéric Sacher; Pierre Bordachar; Jacques Clémenty; Pierre Jaïs; Michel Haïssaguerre; Mélèze Hocini Journal: Heart Rhythm Date: 2010-10-16 Impact factor: 6.343
Authors: Ioan Liuba; Henrik Ahlmroth; Lena Jonasson; Anders Englund; Anders Jönsson; Kåge Säfström; Håkan Walfridsson Journal: Europace Date: 2008-06-03 Impact factor: 5.214
Authors: Hakan Oral; Aman Chugh; Kentaro Yoshida; Jean F Sarrazin; Michael Kuhne; Thomas Crawford; Nagib Chalfoun; Darryl Wells; Warangkna Boonyapisit; Srikar Veerareddy; Sreedhar Billakanty; Wai S Wong; Eric Good; Krit Jongnarangsin; Frank Pelosi; Frank Bogun; Fred Morady Journal: J Am Coll Cardiol Date: 2009-03-03 Impact factor: 24.094