Cardiology and Cardiovascular Research

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Role of NT-pro BNP Levels as a Marker of Early and Late Recurrence in Patients Submitted to Atrial Fibrillation Ablation with Normal Ventricular Function

Received: Dec. 21, 2019    Accepted: Jan. 07, 2020    Published: Jan. 21, 2020
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Abstract

BACKGROUND: Levels of NT-pro BNP has diagnostic and prognostic correlation in patients with heart failure. It is also described as a possible marker of atrial myocardial disease in patients with normal ventricular function associated with atrial fibrillation (AFib). Retrospective and prospective studies have shown that their high dosage prior and few months after AF ablation may be a risk factor for recurrence. OBJECTIVE: Determine if in patients submitted to first AFib ablation the previous levels of NT-pro BNP and at 6 and 12 months after the procedure the modification in these levels by the restoring and maintenance of sinus rhythm can identify patients at higher risk of recurrence of atrial tachyarrhythmias. METHODS AND RESULTS: From June 2015 and June 2017 we sequentially began the NT-pro BNP serial dosing in patients with paroxysmal and persistent AFib with preserved ventricular function. Levels were in the previous week, 6 and 12 months after the procedure. We prospectively analyzed 73 patients submitted to first time ablation of atrial fibrillation. In pre-procedure set 33 patients had elevated concentrations. Of these 15 (45.5%) remained elevated with a 40% recurrence rate at 12-months compared to 5.5% for those which normalized the levels. On the other hand, we had 40 patients that we considered normal NT-pro BNP levels before ablation. Of these 15 (37.5%) do not had a descent of more than 50% from baseline levels had recurrence rates of 33.3% at 12 months. The remaining 25 (62.5%) who show drops > 50% of NT-pro BNP recurrence was of only 8%. Patients who had high concentrations of NT-pro BNP or who did not present a significant decrease in these levels were, respectively, 2.25 and 2.28 times more likely to present atrial arrhythmias recurrences after catheter ablation. CONCLUSION: Our data showed that serial levels of NT-pro BNP in patients with atrial fibrillation and normal ejection fraction might identify those at higher risk of recurrence after successful catheter ablation.

DOI 10.11648/j.ccr.20200401.12
Published in Cardiology and Cardiovascular Research ( Volume 4, Issue 1, March 2020 )
Page(s) 5-10
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Biomarkers, NT-pro BNP, Catheter Ablation, Atrial Fibrillation, Atrial Flutter and Recurrence

References
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[10] Calkins H, Brugada J, Packer DL, Cappato R, Chen S-A, Crijns HJG et. al. HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up. A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation Developed in partnership with the European Heart Rhythm Association (EHRA) and the European Cardiac Arrhythmia Society (ECAS); in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Endorsed and Approved by the governing bodies of the American College of Cardiology, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, and the Heart Rhythm Society. Europace (2007) 9, 335–379. https://doi.org/10.1093/europace/eum120.
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    Fabricio Vassallo, Lucas Luis Meigre, Christiano Cunha, Eduardo Serpa, Hermes Carloni, et al. (2020). Role of NT-pro BNP Levels as a Marker of Early and Late Recurrence in Patients Submitted to Atrial Fibrillation Ablation with Normal Ventricular Function. Cardiology and Cardiovascular Research, 4(1), 5-10. https://doi.org/10.11648/j.ccr.20200401.12

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    Fabricio Vassallo; Lucas Luis Meigre; Christiano Cunha; Eduardo Serpa; Hermes Carloni, et al. Role of NT-pro BNP Levels as a Marker of Early and Late Recurrence in Patients Submitted to Atrial Fibrillation Ablation with Normal Ventricular Function. Cardiol. Cardiovasc. Res. 2020, 4(1), 5-10. doi: 10.11648/j.ccr.20200401.12

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    AMA Style

    Fabricio Vassallo, Lucas Luis Meigre, Christiano Cunha, Eduardo Serpa, Hermes Carloni, et al. Role of NT-pro BNP Levels as a Marker of Early and Late Recurrence in Patients Submitted to Atrial Fibrillation Ablation with Normal Ventricular Function. Cardiol Cardiovasc Res. 2020;4(1):5-10. doi: 10.11648/j.ccr.20200401.12

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  • @article{10.11648/j.ccr.20200401.12,
      author = {Fabricio Vassallo and Lucas Luis Meigre and Christiano Cunha and Eduardo Serpa and Hermes Carloni and Aloyr Simões Junior and Flávia Pezzin and Karla Meira and Alberto Nogueira Junior and Orly Lacerda Junior and Walter Batista Junior and Dalton Hespanhol},
      title = {Role of NT-pro BNP Levels as a Marker of Early and Late Recurrence in Patients Submitted to Atrial Fibrillation Ablation with Normal Ventricular Function},
      journal = {Cardiology and Cardiovascular Research},
      volume = {4},
      number = {1},
      pages = {5-10},
      doi = {10.11648/j.ccr.20200401.12},
      url = {https://doi.org/10.11648/j.ccr.20200401.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ccr.20200401.12},
      abstract = {BACKGROUND: Levels of NT-pro BNP has diagnostic and prognostic correlation in patients with heart failure. It is also described as a possible marker of atrial myocardial disease in patients with normal ventricular function associated with atrial fibrillation (AFib). Retrospective and prospective studies have shown that their high dosage prior and few months after AF ablation may be a risk factor for recurrence. OBJECTIVE: Determine if in patients submitted to first AFib ablation the previous levels of NT-pro BNP and at 6 and 12 months after the procedure the modification in these levels by the restoring and maintenance of sinus rhythm can identify patients at higher risk of recurrence of atrial tachyarrhythmias. METHODS AND RESULTS: From June 2015 and June 2017 we sequentially began the NT-pro BNP serial dosing in patients with paroxysmal and persistent AFib with preserved ventricular function. Levels were in the previous week, 6 and 12 months after the procedure. We prospectively analyzed 73 patients submitted to first time ablation of atrial fibrillation. In pre-procedure set 33 patients had elevated concentrations. Of these 15 (45.5%) remained elevated with a 40% recurrence rate at 12-months compared to 5.5% for those which normalized the levels. On the other hand, we had 40 patients that we considered normal NT-pro BNP levels before ablation. Of these 15 (37.5%) do not had a descent of more than 50% from baseline levels had recurrence rates of 33.3% at 12 months. The remaining 25 (62.5%) who show drops > 50% of NT-pro BNP recurrence was of only 8%. Patients who had high concentrations of NT-pro BNP or who did not present a significant decrease in these levels were, respectively, 2.25 and 2.28 times more likely to present atrial arrhythmias recurrences after catheter ablation. CONCLUSION: Our data showed that serial levels of NT-pro BNP in patients with atrial fibrillation and normal ejection fraction might identify those at higher risk of recurrence after successful catheter ablation.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Role of NT-pro BNP Levels as a Marker of Early and Late Recurrence in Patients Submitted to Atrial Fibrillation Ablation with Normal Ventricular Function
    AU  - Fabricio Vassallo
    AU  - Lucas Luis Meigre
    AU  - Christiano Cunha
    AU  - Eduardo Serpa
    AU  - Hermes Carloni
    AU  - Aloyr Simões Junior
    AU  - Flávia Pezzin
    AU  - Karla Meira
    AU  - Alberto Nogueira Junior
    AU  - Orly Lacerda Junior
    AU  - Walter Batista Junior
    AU  - Dalton Hespanhol
    Y1  - 2020/01/21
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ccr.20200401.12
    DO  - 10.11648/j.ccr.20200401.12
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 5
    EP  - 10
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20200401.12
    AB  - BACKGROUND: Levels of NT-pro BNP has diagnostic and prognostic correlation in patients with heart failure. It is also described as a possible marker of atrial myocardial disease in patients with normal ventricular function associated with atrial fibrillation (AFib). Retrospective and prospective studies have shown that their high dosage prior and few months after AF ablation may be a risk factor for recurrence. OBJECTIVE: Determine if in patients submitted to first AFib ablation the previous levels of NT-pro BNP and at 6 and 12 months after the procedure the modification in these levels by the restoring and maintenance of sinus rhythm can identify patients at higher risk of recurrence of atrial tachyarrhythmias. METHODS AND RESULTS: From June 2015 and June 2017 we sequentially began the NT-pro BNP serial dosing in patients with paroxysmal and persistent AFib with preserved ventricular function. Levels were in the previous week, 6 and 12 months after the procedure. We prospectively analyzed 73 patients submitted to first time ablation of atrial fibrillation. In pre-procedure set 33 patients had elevated concentrations. Of these 15 (45.5%) remained elevated with a 40% recurrence rate at 12-months compared to 5.5% for those which normalized the levels. On the other hand, we had 40 patients that we considered normal NT-pro BNP levels before ablation. Of these 15 (37.5%) do not had a descent of more than 50% from baseline levels had recurrence rates of 33.3% at 12 months. The remaining 25 (62.5%) who show drops > 50% of NT-pro BNP recurrence was of only 8%. Patients who had high concentrations of NT-pro BNP or who did not present a significant decrease in these levels were, respectively, 2.25 and 2.28 times more likely to present atrial arrhythmias recurrences after catheter ablation. CONCLUSION: Our data showed that serial levels of NT-pro BNP in patients with atrial fibrillation and normal ejection fraction might identify those at higher risk of recurrence after successful catheter ablation.
    VL  - 4
    IS  - 1
    ER  - 

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Author Information
  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

  • Department of Electrophysiology of Espirito Santo Cardiology Institute, Brazil and Department of Cardiology of Santa Rita Hospital of Cassia Vitoria, Vitoria, Brazil

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