Asymmetric dimethylarginine concentration and recurrence of atrial tachyarrythmias after catheter ablation in patients with persistent atrial fibrillation
- 233 Downloads
It has been reported that elevation of asymmetric dimethylarginine (ADMA) concentration is involved in atrial fibrillation (AF) process. The purpose of this study was to determine whether ADMA concentration is related to recurrences of AF after catheter ablation.
A total of one hundred and thirty-eight patients with persistent AF (49.91 ± 7.23 years), but without known heart disease, who underwent successful mapping and catheter ablation were included. Serum ADMA levels were measured 1 day before the catheter ablation.
After a mean follow-up period of 285 days (range, 98–651 days), 80 (58%) patients underwent the AF recurrence. Comparing with no AF recurrence group, the serum ADMA concentration, left atrial diameter, and persistent duration of AF in patients with AF recurrence group were significantly increased. Left atrial diameter, persistent duration of AF, and the number of non-pulmonary vein ectopy ablation were increased when serum ADMA concentration was elevated. In addition, AF recurrences were significantly increased when serum ADMA concentration was elevated. A multivariable Cox regression analysis demonstrated that the elevated ADMA concentration [hazard ration (95% CI), 4.59 (1.81–11.62); P = 0.001], the left atrial diameter [1.35 (1.18–1.55), P < 0.001], and the number of non-pulmonary vein ectopy ablation [1.94 (1.18–3.18), P = 0.009] were independent factors associated with the AF recurrence after catheter ablation.
This study demonstrated that (1) serum ADMA concentrations were associated with non-PV ectopies and (2) increased serum ADMA concentrations were associated with higher rate of AF recurrence after catheter ablation in patients with persistent AF, supporting our hypothesis that ADMA might participate in the process of atrial remodeling.
KeywordsAtrial fibrillation Asymmetric dimethylarginine Recurrence Catheter ablation Atrial
This study was fully supported by the Key Science and Technology Program of Heilongjiang Province, China (no. GC10C305-1).
Conflict of interest
- 1.Calkins, H., Brugada, J., Packer, D. L., Cappato, R., Chen, S. A., Crijns, H. J., et al. (2007). HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for personnel, policy, procedures and follow-up. Heart Rhythm, 4, 816–861.PubMedCrossRefGoogle Scholar
- 15.Van Gelder, I. C., Crijns, H. J., Van Gilst, W. H., Verwer, R., & Lie, K. I. (1991). Prediction of uneventful cardioversion and maintenance of sinus rhythm from direct-current electrical cardioversion of chronic atrial fibrillation and flutter. The American Journal of Cardiology, 68(1), 41–46.PubMedCrossRefGoogle Scholar
- 21.Kallergis, E. M., Manios, E. G., Kanoupakis, E. M., Mavrakis, H. E., Kolyvaki, S. G., Lyrarakis, G. M., et al. (2008). The role of the post-cardioversion time course of hs-CRP levels in clarifying the relationship between inflammation and persistence of atrial fibrillation. Heart, 94(2), 133–134.CrossRefGoogle Scholar
- 26.Korantzopoulos, P., Kolettis, T. M., Kountouris, E., Dimitroula, V., Karanikis, P., Pappa, E., et al. (2005). Oral vitamin C administration reduces early recurrence rates after electrical cardioversion of persistent atrial fibrillation and attenuates associated inflammation. International Journal of Cardiology, 10, 102(2), 321–326.CrossRefGoogle Scholar
- 32.Suda, O., Tsutsui, M., Morishita, T., Tasaki, H., Ueno, S., Nakata, S., et al. (2004). Asymmetric dimethylarginine produces vascular lesions in endothelial nitric oxide synthase-deficient mice: involvement of renin-angiotensin system and oxidative stress. Arteriosclerosis, Thrombosis, and Vascular Biology, 24, 1682–1688.PubMedCrossRefGoogle Scholar
- 33.Natale, A., Pisanó, E., Beheiry, S., Richey, M., Leonelli, F., Fanelli, R., et al. (2000). Ablation of right and left atrial premature beats following cardioversion in patients with chronic atrial fibrillation refractory to antiarrhythmic drugs. The American Journal of Cardiology, 1,85(11), 1372–1375.CrossRefGoogle Scholar
- 41.Kurotobi, T., Iwakura, K., Inoue, K., Kimura, R., Okamura, A., Koyama, Y., et al. (2010). A pre-existent elevated C-reactive protein is associated with the recurrence of atrial tachyarrhythmias after catheter ablation in patients with atrial fibrillation. Europace, 12(9), 1213–1218.PubMedCrossRefGoogle Scholar
- 42.Osmancik, P., Peroutka, Z., Budera, P., Herman, D., Stros, P., & Straka, Z. (2010). Changes in cytokine concentrations following successful ablation of atrial fibrillation. European Cytokine Network, 1, 21(4), 278–284.Google Scholar
- 44.Degener, S., Pattberg, S. V., Feuersenger, H., Bansmann, P. M., Shin, D. I., Krummenauer, F., et al. (2007). Plasma natriuretic peptide concentrations as a predictor for successful catheter ablation in patients with drug-refractory atrial fibrillation. Circulation Journal, 71(3), 313–320.CrossRefGoogle Scholar