High-sensitive cardiac troponin T as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency, multielectrode radiofrequency and cryoballoon ablation catheter
Introduction Myocardial injury markers such as high-sensitive cardiac troponin T (hs-cTnT) and creatine kinase MB (CK-MB) reflects the amount of myocardial injury with ablation. The aim of the study was to identify the value of myocardial injury markers to predict outcomes after pulmonary vein isola...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2019-05-01
|
| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/6/1/e000949.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846169676560728064 |
|---|---|
| author | Stefan Osswald Ivan Zeljkovic Sven Knecht Nikola Pavlovic Umut Celikyrut Florian Spies Sarah Burri Dominik Mannhart Loris Peterhans Tobias Reichlin Beat Schaer Christian Sticherling Michael Kuhne |
| author_facet | Stefan Osswald Ivan Zeljkovic Sven Knecht Nikola Pavlovic Umut Celikyrut Florian Spies Sarah Burri Dominik Mannhart Loris Peterhans Tobias Reichlin Beat Schaer Christian Sticherling Michael Kuhne |
| author_sort | Stefan Osswald |
| collection | DOAJ |
| description | Introduction Myocardial injury markers such as high-sensitive cardiac troponin T (hs-cTnT) and creatine kinase MB (CK-MB) reflects the amount of myocardial injury with ablation. The aim of the study was to identify the value of myocardial injury markers to predict outcomes after pulmonary vein isolation (PVI) using three different ablation technologies.Methods Consecutive patients undergoing PVI using a standard 3.5 mm irrigated-tip radiofrequency catheter (RF-group), an irrigated multielectrode radiofrequency catheter (IMEA-group) and a second-generation cryoballoon (CB-group) were analysed. Blood samples to measure injury markers were taken before and 18–24 hours after the ablation. Procedural complications were collected and standardised follow-up was performed. Logistic regression was used to identify predictors of recurrence and complications.Results 96 patients (RF group: n=40, IMEA-group: n=17, CB-group: n=39) undergoing PVI only were analysed (82% male, age 59±10 years). After a follow-up of 12 months, atrial fibrillation (AF) recurred in 45% in the RF-group, 29% in the IMEA-group and 36% in the CB-group (p=0.492). Symptomatic pericarditis was observed in 20% of patients in the RF-group, 15% in the IMEA-group and 5% in the CB-group (p=0.131). None of the injury markers was predictive of AF recurrence or PV reconnection after a single procedure. However, hs-cTnT was identified as a predictor of symptomatic pericarditis (OR: 1.003 [1.001 to 1.005], p=0.015).Conclusion Hs-cTnT and CK-MB were significantly elevated after PVI, irrespective of the ablation technology used. None of the myocardial injury markers were predictive for AF recurrence or PV reconnection, but hs-cTnT release predicts the occurrence of symptomatic pericarditis after PVI. |
| format | Article |
| id | doaj-art-7990ac194210403ba216e3f94f2be65b |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2019-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-7990ac194210403ba216e3f94f2be65b2024-11-12T13:25:11ZengBMJ Publishing GroupOpen Heart2053-36242019-05-016110.1136/openhrt-2018-000949High-sensitive cardiac troponin T as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency, multielectrode radiofrequency and cryoballoon ablation catheterStefan Osswald0Ivan Zeljkovic1Sven Knecht2Nikola Pavlovic3Umut Celikyrut4Florian Spies5Sarah Burri6Dominik Mannhart7Loris Peterhans8Tobias Reichlin9Beat Schaer10Christian Sticherling11Michael Kuhne12Division of Cardiology, University Hospital Basel, Basel, SwitzerlandCardiology, University Hospital Basel, Basel, SwitzerlandCardiology, University Hospital Basel, Basel, SwitzerlandCardiology, Klinicki bolnicki centar Sestre milosrdnice, Zagreb, CroatiaCardiology, Kocaeli Universitesi, Kocaeli, TurkeyCardiology, University Hospital Basel, Basel, SwitzerlandCardiology, University Hospital Basel, Basel, SwitzerlandCardiology, University Hospital Basel, Basel, SwitzerlandCardiology, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiology, Inselspital University Hospital Bern, Bern, SwitzerlandCardiology, University Hospital Basel, Basel, SwitzerlandCardiology Division, Department of Medicine, University Hospital Basel, Basel, SwitzerlandCardiology Division, Department of Medicine, University Hospital Basel, Basel, SwitzerlandIntroduction Myocardial injury markers such as high-sensitive cardiac troponin T (hs-cTnT) and creatine kinase MB (CK-MB) reflects the amount of myocardial injury with ablation. The aim of the study was to identify the value of myocardial injury markers to predict outcomes after pulmonary vein isolation (PVI) using three different ablation technologies.Methods Consecutive patients undergoing PVI using a standard 3.5 mm irrigated-tip radiofrequency catheter (RF-group), an irrigated multielectrode radiofrequency catheter (IMEA-group) and a second-generation cryoballoon (CB-group) were analysed. Blood samples to measure injury markers were taken before and 18–24 hours after the ablation. Procedural complications were collected and standardised follow-up was performed. Logistic regression was used to identify predictors of recurrence and complications.Results 96 patients (RF group: n=40, IMEA-group: n=17, CB-group: n=39) undergoing PVI only were analysed (82% male, age 59±10 years). After a follow-up of 12 months, atrial fibrillation (AF) recurred in 45% in the RF-group, 29% in the IMEA-group and 36% in the CB-group (p=0.492). Symptomatic pericarditis was observed in 20% of patients in the RF-group, 15% in the IMEA-group and 5% in the CB-group (p=0.131). None of the injury markers was predictive of AF recurrence or PV reconnection after a single procedure. However, hs-cTnT was identified as a predictor of symptomatic pericarditis (OR: 1.003 [1.001 to 1.005], p=0.015).Conclusion Hs-cTnT and CK-MB were significantly elevated after PVI, irrespective of the ablation technology used. None of the myocardial injury markers were predictive for AF recurrence or PV reconnection, but hs-cTnT release predicts the occurrence of symptomatic pericarditis after PVI.https://openheart.bmj.com/content/6/1/e000949.full |
| spellingShingle | Stefan Osswald Ivan Zeljkovic Sven Knecht Nikola Pavlovic Umut Celikyrut Florian Spies Sarah Burri Dominik Mannhart Loris Peterhans Tobias Reichlin Beat Schaer Christian Sticherling Michael Kuhne High-sensitive cardiac troponin T as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency, multielectrode radiofrequency and cryoballoon ablation catheter Open Heart |
| title | High-sensitive cardiac troponin T as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency, multielectrode radiofrequency and cryoballoon ablation catheter |
| title_full | High-sensitive cardiac troponin T as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency, multielectrode radiofrequency and cryoballoon ablation catheter |
| title_fullStr | High-sensitive cardiac troponin T as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency, multielectrode radiofrequency and cryoballoon ablation catheter |
| title_full_unstemmed | High-sensitive cardiac troponin T as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency, multielectrode radiofrequency and cryoballoon ablation catheter |
| title_short | High-sensitive cardiac troponin T as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency, multielectrode radiofrequency and cryoballoon ablation catheter |
| title_sort | high sensitive cardiac troponin t as a predictor of efficacy and safety after pulmonary vein isolation using focal radiofrequency multielectrode radiofrequency and cryoballoon ablation catheter |
| url | https://openheart.bmj.com/content/6/1/e000949.full |
| work_keys_str_mv | AT stefanosswald highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT ivanzeljkovic highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT svenknecht highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT nikolapavlovic highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT umutcelikyrut highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT florianspies highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT sarahburri highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT dominikmannhart highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT lorispeterhans highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT tobiasreichlin highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT beatschaer highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT christiansticherling highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter AT michaelkuhne highsensitivecardiactroponintasapredictorofefficacyandsafetyafterpulmonaryveinisolationusingfocalradiofrequencymultielectroderadiofrequencyandcryoballoonablationcatheter |