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Controlled Clinical Trial
. 2008 Sep;31(9):1146-51.
doi: 10.1111/j.1540-8159.2008.01155.x.

Protracted CRP elevation after atrial fibrillation ablation

James M McCabe  1 , Lisa M Smith, Zian H Tseng, Nitish Badhwar, Byron K Lee, Randall J Lee, Melvin M Scheinman, Jeffrey E Olgin, Gregory M Marcus
Affiliations
Controlled Clinical Trial

Protracted CRP elevation after atrial fibrillation ablation

James M McCabe et al. Pacing Clin Electrophysiol. 2008 Sep.

Abstract

Background: Atrial fibrillation (AF) has been linked to an inflammatory process detected through various biomarkers, including C-Reactive Protein (CRP). Early recurrence of AF within the first 3 months after curative AF ablation is not felt to reflect success or failure of the procedure. We hypothesized that this early recurrence is due to an inflammatory response to the ablation itself. We therefore sought to evaluate levels of CRP after AF ablation.

Methods: We prospectively enrolled subjects undergoing AF ablation. A control group of patients undergoing ablation for supraventricular tachycardia (SVT) was also enrolled. Each patient had CRP drawn on the day of the procedure (prior to ablation) and during their first follow-up (median 49 days, interquartile range [IQR] 37-93) and second follow-up (median 147 days, IQR 141-257) clinic visits. Patient interviews were performed and medical histories reviewed for evidence of recurrent AF prior to the first follow-up.

Results: CRP levels significantly increased from baseline to first follow-up in the AF ablation group (P = 0.0017). CRP did not significantly change after SVT ablation (P = 0.92). Seventeen (45%) of the AF subjects exhibited recurrence of AF prior to first follow-up. After adjusting for multiple potential confounders, AF ablation patients with recurrent AF prior to their first follow-up had a statistically significant greater odds of having an increase in CRP (OR 21, 95% CI 1.1-417, P = 0.045).

Conclusions: AF ablation generates an inflammatory response that persists for several weeks. This inflammation may explain early recurrence of AF after curative ablation.

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Conflict of interest statement

Author disclosures/ potential conflicts of interest: None

Figures

Figure 1
Figure 1
Median levels of CRP after atrial fibrillation and supraventricular tachycardia ablation. See text for median time to first and second follow-up visits. Y error bars denote interquartile ranges of CRP.
Figure 2
Figure 2
Median baseline and first follow-up CRP levels of atrial fibrillation ablation patients with and without evidence of recurrent atrial fibrillation by first follow-up. Solid and dashed Y error bars denote interquartile ranges for those with and without recurrent atrial fibrillation, respectively. Although the median CRP level declined in those without recurrent atrial fibrillation, the p value of 0.050 represents the overall increase in CRP (as demonstrated by the interquartile range).
See this image and copyright information in PMC

References

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