P320Response of high-sensitive C-reactive protein to catheter ablation of atrial fibrillation and its relation with rhythm outcome

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Abstract

Background

High-sensitive C-reactive protein (hs-CRP) has been linked with atrial fibrillation (AF) but its role in predicting AF recurrences after catheter ablation is controversial. This study investigated the possible association between hs-CRP as well as hs-CRP changes and rhythm outcome after AF catheter ablation.

Methods

We studied 68 consecutive patients with AF undergoing catheter ablation. hs-CRP levels were measured using commercially available assays before and 6 months after catheter ablation. Serial 7-day Holter ECGs were used to detect AF recurrences.

Results

Early AF recurrence (ERAF, within one week) was observed in 38 %, while late AF recurrence (LRAF, between 3 and 6 months) occurred in 18 % of the patients. None of the baseline clinical or echocardiographic variables was predictive of ERAF or LRAF. Baseline hs-CRP measured 2.07 ± 1.1 μg/ml and was not associated with ERAF and LRAF. At 6 months, hs-CRP levels were comparable with baseline values (2.14 ± 1.19 μg/ml, p=0.409) and were also not related with LRAF. However, patients with LRAF showed an hs-CRP increase from 2.03 ± 0.61 to 2.62 ± 1.52 μg/ml (p=0.028). Patients with an hs-CRP change in the upper tertile ( > 0.2 μg/ml) had LRAF in 32 % as opposed to 11 % (p=0.042) in patients in the lower ( < -0.3 μg/ml) or intermediate (-0.3 — 0.2 μg/ml) tertile.

Conclusions

Changes in hs-CRP but not baseline hs-CRP are associated with rhythm outcome after AF catheter ablation. This finding points to a link between an inflammatory response and AF recurrence in this setting.

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