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. 2018 Nov;46(11):4518-4526.
doi: 10.1177/0300060518767768. Epub 2018 Sep 5.

Serum neuron-specific enolase, a marker of neuronal injury, increases after catheter ablation of atrial fibrillation

Aynur Acibuca  1 , Veysel Kutay Vurgun  1 , Demet Menekse Gerede  1 , Ali Timucin Altin  1 , Inci Sule Gul  2 , Basar Candemir  1 , Canan Isikay Togay  2 , Mustafa Kilickap  1 , Omer Akyurek  1
Affiliations

Serum neuron-specific enolase, a marker of neuronal injury, increases after catheter ablation of atrial fibrillation

Aynur Acibuca et al. J Int Med Res. 2018 Nov.

Abstract

Objective: Catheter ablation of atrial fibrillation (AF) can lead to thromboembolic complications, especially stroke. We measured the periprocedural serum neuron-specific enolase (NSE) level, which is a biomarker of neuronal injury, after ablation of AF.

Methods: Forty-three patients with paroxysmal AF were prospectively enrolled before radiofrequency ablation. A neurological examination was performed before and after the procedure. The serum NSE level was determined before and at the end of the procedure and at 2, 24, and 48 h after the procedure.

Results: No patients developed new neurological deficits. However, the median (interquartile range) NSE level increased after ablation from 6.7 (3.87) ng/mL at baseline to 11.48 (5.3) ng/mL at 24 h postoperatively. The NSE level exceed the upper reference limit of normal (17 ng/mL) in 14 patients (33%), and these patients were found to have a larger left atrium.

Conclusions: Serum NSE increased in most of the patients undergoing ablation for AF, and it exceeded the normal limit in one-third of the patients. Although NSE is a biomarker of neuronal injury, the clinical importance of this increase after AF ablation and its relationship with the left atrial diameter should be evaluated in a longitudinal study.

Keywords: Atrial fibrillation; catheter ablation; cerebral embolism; pulmonary vein isolation; serum neuron-specific enolase; thromboembolism.

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Figures

Figure 1.
Figure 1.
Median NSE levels of 43 patients. The samples were collected before the procedure (NSE-pre), at the end of ablation (NSE-post), 2 h after ablation (NSE@2h), 24 h after ablation (NSE@24h), and 48 h after ablation (NSE@48h). NSE, neuron-specific enolase.
See this image and copyright information in PMC

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