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Protracted CRP elevation after atrial fibrillation ablation.

James M McCabe1, Lisa M Smith, Zian H Tseng

  • 1Division of Cardiology, Electrophysiology Section, University of California, San Francisco, California, USA.

Pacing and Clinical Electrophysiology : PACE
|October 7, 2008
PubMed
Summary

Atrial fibrillation (AF) ablation causes inflammation, indicated by increased C-Reactive Protein (CRP) levels. This inflammation may explain early AF recurrence after the procedure.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Inflammation Research

Background:

  • Atrial fibrillation (AF) is associated with inflammation, with C-Reactive Protein (CRP) as a key biomarker.
  • Early AF recurrence post-ablation (within 3 months) is common and not indicative of procedural success or failure.
  • The study hypothesizes that ablation-induced inflammation contributes to early AF recurrence.

Purpose of the Study:

  • To investigate C-Reactive Protein (CRP) levels following AF ablation.
  • To determine if the inflammatory response post-ablation correlates with early AF recurrence.

Main Methods:

  • Prospective enrollment of patients undergoing AF ablation and a control group undergoing supraventricular tachycardia (SVT) ablation.
  • CRP levels measured pre-ablation and at two follow-up visits (median 49 and 147 days).
  • Patient interviews and medical history review for AF recurrence prior to the first follow-up.

Main Results:

  • CRP levels significantly increased from baseline to first follow-up in the AF ablation group (P = 0.0017), but not in the SVT group (P = 0.92).
  • 45% of AF patients experienced recurrence before the first follow-up.
  • Recurrent AF was associated with a significantly higher likelihood of increased CRP levels (OR 21, P = 0.045) after adjusting for confounders.

Conclusions:

  • AF ablation triggers a sustained inflammatory response lasting several weeks.
  • This post-ablation inflammation is a likely cause of early AF recurrence.