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N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation

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Abstract

Aims

We investigated the relationship between arrhythmia burden, left atrial volume (LAV) and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) at baseline and after long-term follow-up of atrial fibrillation (AF) ablation.

Methods

We studied 38 patients (23 paroxysmal, 6 women, mean age 56 ± 11) scheduled for AF ablation. LAV was calculated on the basis of computed tomography images at baseline and long-term follow-up, and arrhythmia burden was graded from self-reported frequency and duration of AF episodes.

Results

After a mean period of 22 ± 5 months, 28/38 patients (11/15 persistent) were free from AF recurrence. At baseline there were no differences in mean LAV (125 vs. 130 cm3, p = 0.7) or median NT-pro-BNP (33.5 vs. 29.5 pmol/L, p = 0.9) between patients whose ablation had been successful or otherwise. At long-term follow-up, there was a marked decrease in LAV (105 vs. 134 cm3, p < 0.05) and level of NT-pro-BNP (7 vs. 17.5 pmol/L, p < 0.05) in the successful ablation patients. NT-pro-BNP correlated with LAV both at baseline (r = 0.71, p < 0.001) and at follow-up (r = 0.57, p < 0.001). Arrhythmia burden correlated with both NT-pro-BNP (r = 0.47, p < 0.01) and LAV (r = 0.52, p < 0.01). A decrease in NT-pro-BNP at follow-up of >25% of baseline value had a specificity of 0.89 and a sensitivity of 0.6 (receiver operator characteristics, accuracy 0.82) for ablation success.

Conclusions

NT-pro-BNP correlates with LAV and arrhythmia burden in AF patients and both NT-pro-BNP and LAV decrease significantly after successful ablation. A decrease in NT-pro-BNP of >25% from the baseline value could be useful as a marker of ablation success.

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Acknowledgements

This study was supported by a grant from the Norwegian Foundation for Health and Rehabilitation.

Conflict of interest

Chen and Solheim received consultant fees from St. Jude Medical, and Peter Schuster was a recipient of Nordic electrophysiological research grant from Biosense Webster.

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Authors and Affiliations

  1. Institute of Medicine, University of Bergen, Bergen, Norway

    Eivind Solheim, Alessandro De Bortoli, Peter Schuster, Ole-Jørgen Ohm & Jian Chen

  2. Department of Heart Disease, Haukeland University Hospital, NO-5021, Bergen, Norway

    Eivind Solheim, Morten Kristian Off, Per Ivar Hoff, Peter Schuster & Jian Chen

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  1. Eivind Solheim
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  2. Morten Kristian Off
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  3. Per Ivar Hoff
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Correspondence to Eivind Solheim.

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Solheim, E., Off, M.K., Hoff, P.I. et al. N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation. J Interv Card Electrophysiol 34, 129–136 (2012). https://doi.org/10.1007/s10840-011-9629-2

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