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ȣ - 500442 108 |
| Plasma Nerve Growth Factor Concentrations and the Recurrence of Atrial Fibrillation After Radiofrequency Catheter ablation.
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| 가톨릭 의과대학 순환기 내과¹ ,Cedars-Sinai Medical Center and David Geffen School of Medicine² |
| 오용석, 김지훈¹, 최윤석¹, 이동현¹, 박철수¹, 윤호중¹, 이만영¹, 정욱성¹, 승기배¹, 노태호¹ , 홍순조¹ , Shengmei Zhou², Lan S Chen², Peng-Sheng Chen² |
We have previous reported that radiofrequency catheter ablation (RFCA) in humans is associated with a significantly increased plasma nerve growth factor (NGF) concentration. Whether or not the magnitude of NGF increase is predicative or post-ablation atrial fibrillation (AF) recurrence is not clear. We studied 17 patients who underwent RFCA for (AF) (N=15), or with atrial flutter (N=2). The latter 2 patients also had AF before procedure. The mean age was 51±8.8 years and 12 patients were men. The procedure time was 308±58 min for AF ablation, which included Lasso guided 4 pulmonary vein (PV) ostial ablation and creating cavotricupid isthmus block. The procedure times were 165±63 min for atrial flutter ablation, which included cavotricuspid isthmus block only. Average RF application was 73.5±15.2 min for AF and 52.9±47 min for atrial flutter. The patients were followed up for 11±1 months during which 6 patients had recurrent AF (N=5) or atrial flutter (N=1). In 2 of the 6 patients, the AF was transient. The remaining 11 patients had no recurrence of arrhythmia. The 6 patients with AF recurrence had NGF increased from 7.36±3.01 ng/ml (immediately after ablation) to 36.60±26.63 ng/ml in postoperative day (POD) 1 and 30.01±19.81 ng/ml in POD 2. The average increase was 5.05±3.75 fold (range 1.77 to 11.83) in POD 1. In contrast, the 11 patients without AF recurrence had NGF increased from 17.21±12.93 ng/ml (immediately post-ablation) to 26.43±17.60 ng/ml in POD 1. The average increase was 1.79±0.57 fold (range 0.88-2.53, P=0.039 compared with patients with recurrence) in POD1. Among the 6 patients with recurrent AF or flutter, 4 had an NGF increase of > 2.53 fold. Therefore, a NGF increase of > 2.53 fold in POD1 is associated with 67% probability of post-ablation arrhythmia recurrence. On the other hand, if NGF increase is ≤ 2.53 fold, there is a 100% probability that the patient will be arrhythmia free during follow up. We conclude that there was a significant association between the magnitude of NGF increase and the postablation AF recurrence in patients underwent radiofrequency catheter ablation.
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