Article

Markers of inflammation before and after curative ablation of atrial flutter.

Division of Cardiology, Electrophysiology Section, University of California, San Francisco, San Francisco, California 94143-1354, USA.
Heart Rhythm (Impact Factor: 4.92). 03/2008; 5(2):215-21. DOI: 10.1016/j.hrthm.2007.10.007
Source: PubMed

ABSTRACT Atrial arrhythmias are associated with inflammation. The cause and effect of the association are unknown.
The purpose of this study was to test the hypothesis that atrial tachyarrhythmias contribute to inflammation.
We performed a prospective observational study wherein C-reactive protein (CRP) and interleukin-6 (IL-6) levels from the femoral vein and coronary sinus (CS) were compared before curative ablation for atrial flutter (AFL; n = 59) and paroxysmal supraventricular tachycardia (SVT; n = 110). Follow-up levels were obtained at 1 and 6 months.
Peripheral levels of both biomarkers were significantly higher in the AFL group. After multivariate adjustment, only those in the AFL group who presented in AFL or atrial fibrillation (AF) had significantly elevated CRP levels (odds ratio 1.26; P = .033). Levels of each marker were similar in the CS and peripheral blood in the SVT group; in the AFL group, both CRP and IL-6 were significantly lower in the CS than in the periphery (P = .0076 and P = .0021, respectively). CRP was significantly lower a median of 47 days after AFL ablation (from a median of 6.28 mg/L to a median of 2.92 mg/L; P = .028) and remained reduced at second follow-up. IL-6 decreased across three time points after AFL ablation (P = .002). No reduction in inflammatory biomarkers was observed after SVT ablation.
CRP and IL-6 levels are elevated in patients presenting in AFL. Given the lower CS values in these patients, their origin appears to be systemic rather than cardiac. Because these levels significantly fall after ablation of AFL, the atrial tachyarrhythmia appears to be the cause (not the effect) of the inflammation.

1 Bookmark
 · 
79 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Inflammation is a pathological condition known since ancient times. Recent discoveries of inflammatory markers have given new insights into the role of inflammation in the pathogenesis of arrhythmias. This article reviews global data on possible correlations between inflammation - acute or chronic - and cardiac arrhythmias. The authors discuss the role of inflammation in patients with supraventricular and ventricular arrhythmias. Collected data support the hypothesis that the inflammatory process may be an important factor in cardiac rhythm disturbances.
    Expert Review of Cardiovascular Therapy 07/2014;
  • International Journal of Cardiology 07/2014; · 6.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Nonvalvular atrial fibrillation (AF) confers a five-fold increased risk of stroke. Whether catheter ablation (CA) subsequently decreases prothrombotic risk is unknown. Objective We sought to assess the long-term effects of CA for AF on prothrombotic risk. Methods Fifty-seven patients undergoing CA for AF were prospectively studied. Platelet activation (CD62P [platelet P-selectin] and PAC-1 [glycoprotein IIb/IIIa] expression) and endothelial function (asymmetric dimethylarginine [ADMA] levels) were measured at baseline and 6-months post-ablation. Results Thirty-seven (65%) patients remained in sinus rhythm (SR-group) and 20 (35%) sustained AF recurrence (AF-recurrence group) at 6-months. Patients with AF-recurrence were older, had a higher proportion of hypertension and long-standing persistent AF. There were no significant differences in CD62P (p=0.3), PAC-1 (p=0.1) and ADMA (p=0.7) levels at baseline between the two groups. In the SR-group, markers of platelet activation decreased significantly at 6-month follow-up compared to baseline; log CD62P % 0.79±0.28 vs. 1.03±0.27 (p<0.05) and log PAC-1 % 0.22±0.58 vs. 0.89±0.31 (p<0.01). This was not significant in the AF-recurrence group (p=0.8, log CD62P; p=0.1, log PAC-1). For endothelial function, ADMA levels decreased significantly at 6-months compared to baseline in the SR-group (log ADMA microM/L 0.15±0.02 vs. 0.17±0.04; p<0.05), but did not alter significantly in the AF-recurrence group (p=0.4, log ADMA). Conclusion Catheter ablation and successful maintenance of SR leads to a decrease in platelet activation and improvement in endothelial function in patients with AF. These findings suggest that AF is an important determinant of the prothrombotic state and that this may be reduced by successful catheter ablation.
    Heart Rhythm 11/2014; · 4.92 Impact Factor

Full-text (2 Sources)

Download
32 Downloads
Available from
Jun 1, 2014