Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation

Michela Casella, Antonio Dello Russo, Eleonora Russo, Ghaliah Al-Mohani, Pasquale Santangeli, Stefania Riva, Gaetano Fassini, Massimo Moltrasio, Ester Innocenti, Daniele Colombo, Fabrizio Bologna, Gennaro Izzo, G. Joseph, Luigi Di Biase, Andrea Natale, Claudio Tondo

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Our study aims to compare acute myocardial injury biomarker rise after atrial fibrillation ablation performed with different technologies.

Methods and Results: One hundred and ten patients were treated with pulmonary vein isolation with 4 different technologies: open-irrigated tip radiofrequency (RF) catheter in 35 patients (Group A), cryoballoon in 35 patients (Group B), visually guided laser balloon in 20 patients (Group C), open-irrigated tip RF catheter with contact-force-sensing technology in 20 patients (Group D). Post-procedure samples of cardiac troponin I (cTnI) and creatinine kinase-MB (CK-MB) were collected at 19 ± 3 h and 43 ± 3 h after ablation. At the first postprocedural sample, cTnI and CK-MB levels were found elevated in all 110 patients with a median value of 2.11 ng/mL and 8.95 ng/mL, respectively. Group B showed cTnI levels increased (median 5.96 ng/mL) compared to other groups (median Group A: 1.72 ng/mL, Group C: 1.54 ng/mL, Group D: 2.0 ng/mL; p < 0.001). Also CK-MB levels resulted higher in cryoablation (median 26.4 ng/mL) compared to other groups (median Group A: 6.40 ng/mL, Group C: 7.15 ng/mL, Group D: 6.50 ng/mL; p < 0.001). No significant association was observed between biomarker levels and recurrences of atrial fibrillation after a mean follow-up of 369 ± 196 days.

Conclusions: Highest markers for myocardial injury were observed in the cryoballoon group. It is possible that a longer delivery energy duration and other factors affecting lesion size resulted in higher amount of cardiac injury in cryoablation. The higher levels of cardiac biomarkers did not translate into a better outcome and its physiologic significance is unknown.

Original languageEnglish (US)
Pages (from-to)516-523
Number of pages8
JournalCardiology Journal
Volume21
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Catheter Ablation
Atrial Fibrillation
Biomarkers
Troponin I
Wounds and Injuries
Creatinine
Cryosurgery
Phosphotransferases
Technology
Catheters
Pulmonary Veins
Lasers
Recurrence

Keywords

  • Atrial fibrillation ablation
  • Cardiac biochemical markers
  • Cardiac troponin I
  • Creatinine kinase-MB
  • Myocardial injury

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Casella, M., Russo, A. D., Russo, E., Al-Mohani, G., Santangeli, P., Riva, S., ... Tondo, C. (2014). Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation. Cardiology Journal, 21(5), 516-523. https://doi.org/10.5603/CJ.a2013.0153

Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation. / Casella, Michela; Russo, Antonio Dello; Russo, Eleonora; Al-Mohani, Ghaliah; Santangeli, Pasquale; Riva, Stefania; Fassini, Gaetano; Moltrasio, Massimo; Innocenti, Ester; Colombo, Daniele; Bologna, Fabrizio; Izzo, Gennaro; Joseph, G.; Di Biase, Luigi; Natale, Andrea; Tondo, Claudio.

In: Cardiology Journal, Vol. 21, No. 5, 2014, p. 516-523.

Research output: Contribution to journalArticle

Casella, M, Russo, AD, Russo, E, Al-Mohani, G, Santangeli, P, Riva, S, Fassini, G, Moltrasio, M, Innocenti, E, Colombo, D, Bologna, F, Izzo, G, Joseph, G, Di Biase, L, Natale, A & Tondo, C 2014, 'Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation', Cardiology Journal, vol. 21, no. 5, pp. 516-523. https://doi.org/10.5603/CJ.a2013.0153
Casella, Michela ; Russo, Antonio Dello ; Russo, Eleonora ; Al-Mohani, Ghaliah ; Santangeli, Pasquale ; Riva, Stefania ; Fassini, Gaetano ; Moltrasio, Massimo ; Innocenti, Ester ; Colombo, Daniele ; Bologna, Fabrizio ; Izzo, Gennaro ; Joseph, G. ; Di Biase, Luigi ; Natale, Andrea ; Tondo, Claudio. / Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation. In: Cardiology Journal. 2014 ; Vol. 21, No. 5. pp. 516-523.
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T1 - Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation

AU - Casella, Michela

AU - Russo, Antonio Dello

AU - Russo, Eleonora

AU - Al-Mohani, Ghaliah

AU - Santangeli, Pasquale

AU - Riva, Stefania

AU - Fassini, Gaetano

AU - Moltrasio, Massimo

AU - Innocenti, Ester

AU - Colombo, Daniele

AU - Bologna, Fabrizio

AU - Izzo, Gennaro

AU - Joseph, G.

AU - Di Biase, Luigi

AU - Natale, Andrea

AU - Tondo, Claudio

PY - 2014

Y1 - 2014

N2 - Background: Our study aims to compare acute myocardial injury biomarker rise after atrial fibrillation ablation performed with different technologies.Methods and Results: One hundred and ten patients were treated with pulmonary vein isolation with 4 different technologies: open-irrigated tip radiofrequency (RF) catheter in 35 patients (Group A), cryoballoon in 35 patients (Group B), visually guided laser balloon in 20 patients (Group C), open-irrigated tip RF catheter with contact-force-sensing technology in 20 patients (Group D). Post-procedure samples of cardiac troponin I (cTnI) and creatinine kinase-MB (CK-MB) were collected at 19 ± 3 h and 43 ± 3 h after ablation. At the first postprocedural sample, cTnI and CK-MB levels were found elevated in all 110 patients with a median value of 2.11 ng/mL and 8.95 ng/mL, respectively. Group B showed cTnI levels increased (median 5.96 ng/mL) compared to other groups (median Group A: 1.72 ng/mL, Group C: 1.54 ng/mL, Group D: 2.0 ng/mL; p < 0.001). Also CK-MB levels resulted higher in cryoablation (median 26.4 ng/mL) compared to other groups (median Group A: 6.40 ng/mL, Group C: 7.15 ng/mL, Group D: 6.50 ng/mL; p < 0.001). No significant association was observed between biomarker levels and recurrences of atrial fibrillation after a mean follow-up of 369 ± 196 days.Conclusions: Highest markers for myocardial injury were observed in the cryoballoon group. It is possible that a longer delivery energy duration and other factors affecting lesion size resulted in higher amount of cardiac injury in cryoablation. The higher levels of cardiac biomarkers did not translate into a better outcome and its physiologic significance is unknown.

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KW - Atrial fibrillation ablation

KW - Cardiac biochemical markers

KW - Cardiac troponin I

KW - Creatinine kinase-MB

KW - Myocardial injury

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