Department of Cardiology, The Heart Centre, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Scand Cardiovasc J. 2009;43(5):285-91. doi: 10.1080/14017430802653676.
The aim of this study was to assess the predictive value of inflammatory markers in patients with paroxysmal/persistent atrial fibrillation (AF) treated with radiofrequency (RF) catheter ablation.
Forty-six consecutive patients, mean age 55 years (range 31 - 81 yrs), with paroxysmal or persistent AF were treated with either segmental or circumferential pulmonary vein isolation ablation technique. All patients presented with sinus rhythm on inclusion. Holter monitoring lasting at least 14 days was performed before ablation and after 3 months. Recurrent symptomatic AF or atrial tachycardia >10 minutes was considered failure and patients were offered a second ablation session. Interleukin-6 and high-sensitivity C-reactive protein were measured prior to ablation and at follow-up visits.
After a maximum of two ablations, 19 patients (41%) had SR without recurrence of AF after 12 months. Patients in SR had significantly lower left atrium diameter (p = 0.007) and lower values of both IL-6 (p = 0.007) and hs-CRP (p = 0.018) at baseline before ablation. IL-6 concentration prior to ablation was an independent predictor of recurrent AF (p = 0.027).
In patients with a history of paroxysmal or persistent AF treated with RF catheter ablation, elevated levels of IL-6 and hs-CRP before ablation are independent predictors of recurrence of AF.
本研究旨在评估炎症标志物在接受射频（RF）导管消融治疗阵发性/持续性心房颤动（AF）患者中的预测价值。
46 例连续患者，平均年龄 55 岁（范围 31-81 岁），患有阵发性或持续性 AF，采用节段或环形肺静脉隔离消融技术进行治疗。所有患者在纳入时均表现为窦性心律。消融前和 3 个月后进行至少 14 天的动态心电图监测。复发有症状的 AF 或持续>10 分钟的房性心动过速被认为是失败，患者被提供第二次消融治疗。在消融前和随访时测量白细胞介素-6 和高敏 C 反应蛋白。
在最多两次消融后，19 例（41%）患者在 12 个月后无 SR 且无 AF 复发。SR 患者的左心房直径明显较小（p=0.007），消融前的白细胞介素-6（p=0.007）和高敏 C 反应蛋白（p=0.018）值也较低。消融前白细胞介素-6 浓度是 AF 复发的独立预测因子（p=0.027）。
在接受 RF 导管消融治疗的阵发性或持续性 AF 病史患者中，消融前升高的白细胞介素-6 和高敏 C 反应蛋白水平是 AF 复发的独立预测因子。
