The Role of Cardiac Biomarkers in Prediction of Outcome in Atrial Fibrillation Patients Undergoing Catheter Ablation
| Status: | Archived |
|---|---|
| Conditions: | Atrial Fibrillation |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/1/2011 |
| Start Date: | June 2010 |
| End Date: | June 2011 |
This prospective study aims;
1. To assess if pre-ablation levels of inflammatory biomarkers serve as independent
predictors of procedure outcome
2. To evaluate the inflammatory activation following catheter ablation by measuring
serum-biomarker levels 24-hours after the procedure and examine the predictive role in
procedure success
3. To determine if a change in the baseline level of certain inflammatory biomarkers at
3-months post-ablation period has any correlation with the long-term outcome in
patients with atrial fibrillation
4. To study the association of certain biomarkers with specific types of AF (paroxysmal or
persistent or long standing persistent)
AF is the most common arrhythmia in clinical practice, affecting > 2.3 million people in US.
It increases dramatically with age and is seen in as many as 9% of individuals by the age of
80 (1). A major cause of stroke, AF is also associated with a 2-fold increase in mortality
(1).
Symptomatic AF has been demonstrated to be consistently associated with elevated
inflammatory activity in the atrial tissue as evidenced by the facts that AF occurs in 40%
of patients following cardiac bypass surgery and 50% of patients undergoing valvular surgery
(2). Recent studies have also demonstrated that elevated CRP level can increase the risk of
AF up to 31% (2). Oxidative damage experienced during AF leads to myocardial necrosis which
in turn induces low-grade inflammation resulting in eventual fibrosis of the atrial
myocardium. Thus, inflammation can be responsible for adverse structural and electrical
remodeling of the cardiac tissue which can further perpetuate the existence, maintenance,
and recurrence of this arrhythmia.
Radiofrequency catheter ablation (RFCA) has evolved as a promising curative therapy for
drug-refractory AF. However, the recurrence of AF after RFCA is a common clinical problem,
occurring in 25-50% of patients in the follow-up period (3) and some patients undergo
multiple ablation procedures before being cured of the arrhythmia. Published retrospective
studies have demonstrated that systemic inflammation generated during AF ablation is
associated with fewer early arrhythmia recurrences (4). Therefore, measurement of
inflammatory markers within 24 hours of RFCA could be helpful in further exploration of any
association between the degree of inflammatory activation and procedure outcome.
Systemic inflammatory activation is characterized by increased circulating levels of several
biomarkers for prolonged periods. Thus, examination of these biomarkers at 3-months
post-procedure may provide critical insight into understanding the role of inflammation in
achievement of long-term success of catheter ablation in AF patients.
Rules-Based Medicine, Inc (RBM) at 3300 Duval Road Austin, TX 78759 has developed biomarker
panels that have been validated to detect early signs of inflammation. RBM will process the
blood samples on a preliminary panel of ~40 biomarkers which are presumed to be possible
predictors of procedural outcomes in RFCA in AF patients.
We found this trial at
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