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Europace Advance Access published online on August 1, 2007
Europace, doi:10.1093/europace/eum157
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Plasma brain natriuretic peptide level after radiofrequency catheter ablation of paroxysmal, persistent, and permanent atrial fibrillation

Takumi Yamada1,*, Yoshimasa Murakami2, Taro Okada2, Naoki Yoshida2, Junji Toyama2, Yukihiko Yoshida3, Naoya Tsuboi3, Yasuya Inden4, Makoto Hirai4 and Toyoaki Murohara4

1 Cardiac Rhythm Management Laboratory, Division of Cardiovascular Diseases, University of Alabama at Birmingham, VH B147, 1670 University Boulevard, 1530 3rd Avenue S, Birmingham, AL 35294-0019, USA; 2 Division of Cardiology, Aichi Prefectural Cardiovascular and Respiratory Center, Ichinomiya, Japan; 3 Division of Cardiology, Nagoya Dai-ni Red Cross Hospital, Cardiovascular Center, Nagoya, Japan; 4 Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

Aims The aim of this study was to investigate the change in plasma brain natriuretic peptide (BNP) level after pulmonary vein isolation (PVI) in paroxysmal (PAF), persistent (Pers-AF), and permanent atrial fibrillation (AF) (Perm-AF) patients.

Methods and results In 96 lone AF patients (PAF = 65, Pers-AF = 17, and Perm-AF = 14), BNP was measured before and 3 months after successful PVIs. At baseline, in all patients, BNP was elevated and was significantly greater in Pers-AF and Perm-AF patients than PAF patients (P<0.05). After 3 months of follow-up following multiple PVIs, AF recurred in 12 (18%) PAF, 7 (41%) Pers-AF, and 8 (57%) Perm-AF patients. In Pers-AF and Perm-AF patients, BNP at baseline did not predict AF recurrence. After the PVIs, BNP significantly decreased in PAF and Pers-AF patients (P = 0.005) but not in Perm-AF patients. An elevated BNP at baseline decreased to within-normal limits in all Pers-AF and Perm-AF patients without AF recurrences. In all seven (23%) patients, whose AF type improved after the PVIs, BNP decreased.

Conclusion The reduction in the BNP level after the PVI seemed to be a marker for a good outcome in AF post-ablation patients.

Key Words: Atrial fibrillation, Brain natriuretic peptide, Pulmonary vein isolation, Radiofrequency catheter ablation

* Corresponding author. Tel: +1 205 975 4724; fax: +1 205 975 4720.E-mail address: takumi-y{at}fb4.so-net.ne.jp

Manuscript submitted 26 May 2007. Accepted after revision 5 July 2007.


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