OBJECTIVE
To study the relationship between the results of catheter-based treatment (CBT) of atrial fibrillation (AF) and laboratory markers — titers of antibodies to the myocardium and the level of NT-proBNP.
MATERIALS AND METHODS
The study included 197 patients with paroxysmal and persistent forms of AF without gross structural disorders of the heart were observed, who underwent cryoballoon ablation of the pulmonary vein ostia and had simultaneously implanted with a loop electrocardiogram recorder (Medtronic Reveal XT). Prior to surgery, blood was sampled, followed by biobanking. The patients returned for an outpatient visit 3, 6, and 12 months after the procedure. If the loop recorder showed a recurrence of AF, the patient was referred for a second electrophysiological examination to evaluate the integrity of the muscular sleeve of the pulmonary veins. In the case of repeated catheter-based surgery, patients were followed up according to a similar schedule and principle.
RESULTS
According to the results of this observation, patients were divided into two groups: patients without recurrence of AF after the first or second catheter-based procedure (venous AF) and patients with recurrence of AF after two catheter-based interventions, despite the achieved isolation of the pulmonary veins as a result of one or two operations (non-venous AF). Then, the laboratory data were analyzed to determine the relationship between them and outcomes of surgical treatment. No relationship was found between antimyocardial antibody titers and CBT outcomes. An association between NT-proBNP and CBT outcomes was revealed.
CONCLUSION
Due to the lack of correlation between myocardial antibody titers and the outcomes of cryoballoon ablation of pulmonary veins in patients with atrial fibrillation, further studies and the search for new predictors of treatment outcomes are necessary. Patients with elevated NT-proBNP levels (more than 375 pg/mL) were 4.125 times more likely to relapse. The new findings help better understand the etiology and pathogenesis of atrial fibrillation. It is crucial to improve the selection of patients for catheter-based treatment and to facilitate the choice of management approach.
