High-Sensitivity Cardiac Troponin I (hs-cTnI) Levels Increase After Radiofrequency Ablation and Are Associated with...

Introduction: There are no data in the literature regarding changes in cardiac troponin levels following radiofrequency ablation (RFA) in patients undergoing ablation for left ventricular summit-derived premature ventricular complexes (LVS-PVCs). In this study, we aimed to investigate changes in high-sensitivity cardiac troponin I (hs-cTnI) levels after RFA in patients with LVS-PVCs and to evaluate the clinical utility of hs-cTnI in this setting. Method: In this retrospective cohort study, 109 patients with LVS-PVCs who underwent RFA between 2017 and 2025 were included. In addition to routine evaluations, hs-cTnI levels were measured 24 h after the procedure in all patients. Long-term procedural success was assessed at 6 months using 24 h Holter electrocardiography. Patients were divided into two groups according to procedural outcome (successful vs. unsuccessful RFA). Results: In patients with LVS-PVCs, the long-term procedural success rate of RFA was 72.5% (n = 79). Compared with patients with unsuccessful long-term outcomes, those with successful RFA had significantly higher hs-cTnI levels, longer QRS-duration, a higher prevalence of RBBB morphology, more frequent ablation at the left coronary cusp (supravalvular/subvalvular), coronary sinus sites (GCV/AIV), and multiple ablation sites, as well as higher maximum RFA power. In contrast, the maximum deflection index and the presence of a pattern break in lead V2 were significantly lower in patients with long-term procedural success. In logistic regression analysis, hs-cTnI level, maximum RFA power, and ablation within the GCV/AIV were independently associated with RFA success (OR = 1.133, 95% CI: 1.043-1.231, p < 0.001; OR = 1.446, 95% CI: 1.176-1.773, p < 0.001; and OR = 3.281, 95% CI: 1.325-21.219, p = 0.002, respectively). ROC curve analysis demonstrated that hs-cTnI and maximum RFA power thresholds of 700 ng/L and 40 W, respectively, predicted RFA success with acceptable sensitivity and specificity. Conclusions: In patients with LVS-PVCs, hs-cTnI levels increase after RFA. Higher hs-cTnI levels are independently associated with procedural success. Measurement of hs-cTnI at 24 h after RFA may serve as an objective and noninvasive marker of procedural success in patients with LVS-PVCs.