Prognostic Implications of the High-Sensitive C-Reactive Protein in the Catheter Ablation of Atrial Fibrillation

Yenn Jiang Lin, Hsuan Ming Tsao, Shih Lin Chang, Li Wei Lo, Ta Chuan Tuan, Yu Feng Hu, Ameya R. Udyavar, Wen Chin Tsai, Chien Jung Chang, Ching Tai Tai, Pi Chang Lee, Kazuyoshi Suenari, Shih Yu Huang, Nguyen Huu Tung, Shih Ann Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

77 Scopus citations

Abstract

Previous studies have reported that increased high-sensitive C-reactive protein (hs-CRP) levels are associated with an inflammatory state. This study investigated the association among hs-CRP, substrate properties, and long-term clinical outcomes after catheter ablation of atrial fibrillation (AF). A total of 137 patients with AF (54 ± 13 years) who underwent mapping and catheter ablation were included. The hs-CRP was measured before the first ablation procedure. The substrate properties (initiating triggers, biatrial mean voltage, and high-frequency sites) of the 2 atria and long-term outcome were investigated in patients in the low hs-CRP group (<75%, 2.92 mg/L) and high hs-CRP group (>75%, 2.92 mg/L). Patients with a higher hs-CRP were associated with an increased number of identified nonpulmonary vein ectopies (34.4% vs 17%, p = 0.034), lower mean left atrial (LA) voltage (1.72 ± 0.73 vs 1.92 ± 0.72 Hz, p = 0.045), and higher-frequency sites in the left atrium (71% vs 37%, p = 0.027). After a median follow-up period of 15 months, the single-procedure success rate (72% vs 53%, p = 0.008) and final success rate after multiple procedures (94% vs 81%, p = 0.02) were higher in the low hs-CRP group. In a multivariable regression model adjusted for other potential covariates, hs-CRP level (p = 0.021) and LA diameter (p = 0.032) were independent predictors of recurrence. In conclusion, baseline CRP levels before the first AF ablation procedure had an independent prognostic value in predicting long-term recurrence. Patients with a high hs-CRP level were associated with an abnormal LA substrate and high incidence of nonpulmonary vein AF sources.

Original languageEnglish
Pages (from-to)495-501
Number of pages7
JournalAmerican Journal of Cardiology
Volume105
Issue number4
DOIs
StatePublished - 15 Feb 2010

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