Background
High-sensitivity troponin I (hsTnI) assays leads to improvements in the detection of myocardial injury and improved risk-stratification of patients with atrial fibrillation (AF) among others. The aim of this study was to investigate the association between post-procedural cardiac biomarkers and clinical outcome in patients undergoing cryo-balloon ablation (CA) of AF.
Methods-Results
A total of 57 patients (mean age 55.1+12.2 years, 50.9% female) with symptomatic paroxysmal AF underwent CA procedure. Two hundred and twenty-eight pulmonary veins (PVs) were attempted for pulmonary vein isolation (PVI) with the second-generation cryo-balloon. The samples of hsTnI, CK-MB mass, and myoglobin were obtained before and at 24 h after ablation. At a mean follow-up of 214.6±24.3 days, the probability of being arrhythmia-free after a single procedure was 86%. Post-procedure hsTnI (p=0.001), left atrial (LA) diameter (p=0.002), duration of AF (p=0.002), mean minimal temperature in the left superior pulmonary vein (p=0.005), and age (p=0.021) were associated with increased AF recurrence. On multivariate analysis, the lower hsTnI level was the only independent predictor for AF recurrence (p=0.012). Greater post-ablation hsTnI level than 4, 40 ng/ml predicted AF recurrence during follow-up with a sensitivity of 86% and a specificity of 96%.
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