Increased NT-pro-B-type natriuretic peptide independently predicts outcome following catheter ablation of atrial fibrillation

Abstract

Aims: To investigate whether NT-proBNP before ablation treatment and after exercise testing has predictive information regarding the clinical outcome following pulmonary vein isolation in patients with atrial fibrillation (AF). Methods: NT-proBNP analysis were obtained before the ablation (before and after exercise test), and repeated at 1, 3, and 12 months after the final procedure. Results: A total of 51 patients were included. At study entry, the median NT-proBNP concentration was 14.0 pmol/L (quartiles: 8.0 and 27.0). After the exercise test, the mean NT-proBNP value increased from 13.0 pmol/L (quartiles: 7.5 and 26.0) to 15.0 pmol/L (quartiles: 9.0 and 34.0), p < 0.001. Following a maximum of two ablations, 22 patients were free of AF while 29 patients experienced recurrent AF. In patients with successful ablation, the mean NT-proBNP concentration at baseline was 10.0 pmol/L (quartiles: 7.0 and 22.2) compared to 22.0 pmol/L (quartiles: 12.0 and 34.5) in patients with ablation failure, p = 0.02. With respect to exercise testing, a trend towards a higher increases during exercise were seen in patients with recurrent AF compared to patients without: 2.0 pmol/L (quartiles 1.9 and 7.0) vs. 1.5 pmol/L (quartiles 0 and 3.0), p = 0.07. A baseline NT-proBNP concentration >15.0 pmol/L was found to be an independent predictor of ablation failure. Conclusion: A significantly lower NT-proBNP concentration at baseline and a trend towards a diminished increase during exercise was seen in patients successfully ablated for AF compared to patients with recurrent AF. A baseline NT-proBNP concentration ≤15 pmol/l independently predicts ablation success.

Key Words::

• Atrial fibrillation
• catheter ablation
• NT-proBNP
• pulmonary vein isolation

Acknowledgements

The authors wish to thank the staff from medical department B, sections 3141 and 3142, the Cardiac Catheterization Laboratory and the Department of Clinical Biochemistry for their help.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the report.