Modulation of SERCA in patients with persistent atrial fibrillation treated by epicardial thoracoscopic ablation: The CAMAF study

Celestino Sardu, Gaetano Santulli, Germano Guerra, Maria Consiglia Trotta, Matteo Santamaria, Cosimo Sacra, Nicola Testa, Valentino Ducceschi, Gianluca Gatta, Michele D’ Amico, Ferdinando Carlo Sasso, Giuseppe Paolisso, Raffaele Marfella

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objectives: To evaluate atrial fibrillation (AF) recurrence and Sarcoplasmic Endoplasmic Reticulum Calcium ATPase (SERCA) levels in patients treated by epicardial thoracoscopic ablation for persistent AF. Background: Reduced levels of SERCA have been reported in the peripheral blood cells of patients with AF. We hypothesize that SERCA levels can predict the response to epicardial ablation. Methods: We designed a prospective, multicenter, observational study to recruit, from October 2014 to June 2016, patients with persistent AF receiving an epicardial thoracoscopic pulmonary vein isolation. Results: We enrolled 27 patients. Responders (n = 15) did not present AF recurrence after epicardial ablation at one-year follow-up; these patients displayed a marked remodeling of the left atrium, with a significant reduction of inflammatory cytokines, B type natriuretic peptide (BNP), and increased levels of SERCA compared to baseline and to nonresponders (p < 0.05). Furthermore, mean AF duration (Heart rate (HR) 1.235 (1.037–1.471), p < 0.05), Left atrium volume (LAV) (HR 1.755 (1.126–2.738), p < 0.05), BNP (HR 1.945 (1.895–1.999), p < 0.05), and SERCA (HR 1.763 (1.167–2.663), p < 0.05) were predictive of AF recurrence. Conclusions: Our data indicate for the first time that baseline values of SERCA in patients with persistent AF might be predictive of failure to epicardial ablative approach. Intriguingly, epicardial ablation was associated with increased levels of SERCA in responders. Therefore, SERCA might be an innovative therapeutic target to improve the response to epicardial ablative treatments.

Original languageEnglish (US)
Article number544
JournalJournal of Clinical Medicine
Volume9
Issue number2
DOIs
StatePublished - Feb 2020

Keywords

  • Calcium channels
  • Epicardial ablation
  • Persistent atrial fibrillation
  • SERCA

ASJC Scopus subject areas

  • Medicine(all)

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