Short‐Term Influence of Radiofrequency Ablation on NT‐proBNP, MR‐proANP, Copeptin, and MR‐proADM in Patients With Atrial Fibrillation: Data From the Observational SMURF Study

Abstract

Background There is limited knowledge on the short‐term influence of radiofrequency ablation ( RFA ) of atrial fibrillation ( AF ) on 2 cardiac biomarkers; the N‐terminal pro‐B‐type natriuretic peptide ( NT ‐pro BNP ) and the midregional fragment of the N‐terminal of pro‐ ANP ( MR ‐pro ANP ) and 2 extracardiac biomarkers; the c‐terminal provasopressin (copeptin) and the midregional portion of proadrenomedullin ( MR ‐pro ADM ). There are also limited data concerning cardiac production of the latter two. Methods and Results We studied 192 consecutive patients eligible for RFA of AF referred to the University Hospital, Linköping, Sweden. NT ‐pro BNP , MR ‐pro ANP , copeptin, and MR ‐pro ADM levels were measured in peripheral blood, the coronary sinus ( CS ), and the left atrium before ablation, and in peripheral blood immediately and the day after RFA . The level of NT ‐pro BNP decreased the day after RFA in participants in AF at the time of RFA , compared to the participants in sinus rhythm who showed a slight increase ( P <0.001). Furthermore, regardless of the actual rhythm, the level of MR ‐pro ANP showed an increase immediately after RFA ( P <0.001), followed by a decrease the day after ablation ( P <0.001). Copeptin level showed a 6‐fold increase immediately after RFA compared to baseline ( P <0.001), whereas MR ‐pro ADM level increased the day after RFA ( P <0.001). Levels of copeptin and MR ‐pro ADM were not higher in the CS compared to peripheral blood. Conclusions RFA of AF is a strong stimulus with a significant and direct impact on different neurohormonal systems. We found no sign of a cardiac release of MR ‐pro ADM or copeptin. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique Identifier: NCT 01553045.