open access

Vol 21, No 5 (2014)
Original articles
Published online: 2014-10-29
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Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation

Michela Casella, Antonio Dello Russo, Eleonora Russo, Ghaliah Al-Mohani, Pasquale Santangeli, Stefania Riva, Gaetano Fassini, Massimo Moltrasio, Ester Innocenti, Daniele Colombo, Fabrizio Bologna, Gennaro Izzo, Joseph G. Gallinghouse, Luigi Di Biase, Andrea Natale, Claudio Tondo
DOI: 10.5603/CJ.a2013.0153
·
Cardiol J 2014;21(5):516-523.

open access

Vol 21, No 5 (2014)
Original articles
Published online: 2014-10-29

Abstract

Background: Our study aims to compare acute myocardial injury biomarker rise after atrial fibrillation ablation performed with different technologies.

Methods and Results: One hundred and ten patients were treated with pulmonary vein isolation with 4 different technologies: open-irrigated tip radiofrequency (RF) catheter in35 patients (Group A), cryoballoon in 35 patients (Group B), visually guided laser balloon in 20 patients (Group C), open-irrigated tip RF catheter with contact-force-sensing technology in 20 patients (Group D). Post-procedure samples of cardiac troponin I (cTnI) and creatinine kinase-MB (CK-MB) were collected at 19 ± 3 h and 43 ± 3 h after ablation. At the first postprocedural sample, cTnI and CK-MB levels were found elevated in all 110 patients with a median value of 2.11 ng/mL and 8.95 ng/mL, respectively. Group B showed cTnI levels increased (median 5.96 ng/mL) compared to other groups (median Group A: 1.72 ng/mL, Group C: 1.54 ng/mL, Group D: 2.0 ng/mL; p < 0.001). Also CK-MB levels resulted higher in cryoablation (median 26.4 ng/mL) compared to other groups (median Group A: 6.40 ng/mL, Group C: 7.15 ng/mL, Group D: 6.50 ng/mL; p < 0.001). No significant association was observed between biomarker levels and recurrences of atrial fibrillation after a mean follow-up of 369 ± 196 days.

Conclusions: Highest markers for myocardial injury were observed in the cryoballoon group. It is possible that a longer delivery energy duration and other factors affecting lesion size resulted in higher amount of cardiac injury in cryoablation. The higher levels of cardiac biomarkers did not translate into a better outcome and its physiologic significance is unknown.

Abstract

Background: Our study aims to compare acute myocardial injury biomarker rise after atrial fibrillation ablation performed with different technologies.

Methods and Results: One hundred and ten patients were treated with pulmonary vein isolation with 4 different technologies: open-irrigated tip radiofrequency (RF) catheter in35 patients (Group A), cryoballoon in 35 patients (Group B), visually guided laser balloon in 20 patients (Group C), open-irrigated tip RF catheter with contact-force-sensing technology in 20 patients (Group D). Post-procedure samples of cardiac troponin I (cTnI) and creatinine kinase-MB (CK-MB) were collected at 19 ± 3 h and 43 ± 3 h after ablation. At the first postprocedural sample, cTnI and CK-MB levels were found elevated in all 110 patients with a median value of 2.11 ng/mL and 8.95 ng/mL, respectively. Group B showed cTnI levels increased (median 5.96 ng/mL) compared to other groups (median Group A: 1.72 ng/mL, Group C: 1.54 ng/mL, Group D: 2.0 ng/mL; p < 0.001). Also CK-MB levels resulted higher in cryoablation (median 26.4 ng/mL) compared to other groups (median Group A: 6.40 ng/mL, Group C: 7.15 ng/mL, Group D: 6.50 ng/mL; p < 0.001). No significant association was observed between biomarker levels and recurrences of atrial fibrillation after a mean follow-up of 369 ± 196 days.

Conclusions: Highest markers for myocardial injury were observed in the cryoballoon group. It is possible that a longer delivery energy duration and other factors affecting lesion size resulted in higher amount of cardiac injury in cryoablation. The higher levels of cardiac biomarkers did not translate into a better outcome and its physiologic significance is unknown.

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Keywords

cardiac biochemical markers, cardiac troponin I, creatinine kinase-MB, atrial fibrillation ablation, myocardial injury

About this article
Title

Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation

Journal

Cardiology Journal

Issue

Vol 21, No 5 (2014)

Pages

516-523

Published online

2014-10-29

DOI

10.5603/CJ.a2013.0153

Bibliographic record

Cardiol J 2014;21(5):516-523.

Keywords

cardiac biochemical markers
cardiac troponin I
creatinine kinase-MB
atrial fibrillation ablation
myocardial injury

Authors

Michela Casella
Antonio Dello Russo
Eleonora Russo
Ghaliah Al-Mohani
Pasquale Santangeli
Stefania Riva
Gaetano Fassini
Massimo Moltrasio
Ester Innocenti
Daniele Colombo
Fabrizio Bologna
Gennaro Izzo
Joseph G. Gallinghouse
Luigi Di Biase
Andrea Natale
Claudio Tondo

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