RESUMEN
Catheter ablation has been demonstrated to reduce atrial fibrillation (AF) recurrence. The mechanisms of AF recurrence after catheter ablation are unknown, and the present study aimed to identify serum proteins associated with AF recurrence. The present prospective study comprised a cohort of patients with AF, which was divided into two groups after one-year follow-up: group 1 included patients with compensated AF after catheter ablation and group 2 included patients with AF recurrence after catheter ablation. Initial microarray profiling of the serum proteins was performed in small subgroups M1 and M2 recruited from groups 1 and 2, respectively, by an antibody microarray to evaluate potentially relevant proteins. The data of initial proteomic profiling identified candidate proteins in groups 1 and 2, and their levels were then measured by ELISA. The data of profiling suggested an overall increase in the levels of RAD51 and p63 proteins in the M2 subgroup versus that in the M1 subgroup, indicating potential relevance of these two proteins to AF recurrence. The results of ELISA of the levels of RAD51 and p63 in the groups 1 and 2 demonstrated an increase in the levels of RAD51 (11.11 ± 4.36 vs 8.45 ± 4.85 ng/mL; P = 0.009) and p63 (165.73 ± 113.75 vs 100.05 ± 37.56 units of normalized optical density; P = 0.0007) in the group 2 (with AF recurrence or substrate AF) compared with that in the group 1 (compensated AF). Thus, RAD51 and p63 were associated with AF recurrence after catheter ablation and may represent possible etiological factors for subsequent outcomes.
RESUMEN
Adenovirus (AdV) has been suggested to be involved in pathogenesis of atrial fibrillation (AF). We aimed to evaluate an association between AdV-specific immunoglobulins G in the serum (AdV-IgG) and AF. The present case-control study comprised two cohorts, including cohort 1 of patients with AF and cohort 2 of asymptomatic subjects. Initially, two groups, MA and MB, were selected from the cohorts 1 and 2, respectively, for serum proteome profiling using an antibody microarray to identify possible relevant protein targets. The data of microarray analysis indicated a possible overall increase in the total adenovirus signals in the group MA vs. group MB, suggesting potential relevance of adenoviral infection to AF. Then, the groups A (with AF) and B (control) were selected from the cohorts 1 and 2, respectively, to assay the presence and levels of AdV-IgG- by ELSA. The prevalence of AdV-IgG-positive status demonstrated a 2-fold increase in the group A (AF) compared with that in the group B (asymptomatic subjects); odds ratio 2.06 (95%CI: 1.11-3.84; P = 0.02). The prevalence of obesity demonstrated an approximately 3-fold increase in AdV-IgG-positive patients of the group A compared with that in AdV-IgG-negative patients of the same group A (odds ratio 2.7; 95% CI: 1.02-7.1; P = 0.04). Thus, AdV-IgG-positive reactivity was independently associated with AF, and AF was independently associated with BMI, indicating that adenoviral infection may be a possible etiological factor for AF.
RESUMEN
BACKGROUND: Early recurrences of atrial arrhythmias (ERAA) after atrial fibrillation (AF) catheter ablation do not predict procedural failure. A well-demarcated homogeneous lesion delivered by cryoballoon is less arrhythmogenic, and the recommended three-months blanking period may not refer to cryoballoon ablation (CBA). OBJECTIVE: We aimed to evaluate the predictive role of ERAA after second-generation CBA using an implantable loop recorder. METHODS: This prospective observational study enrolled 100 patients (58 males, median age 58) with paroxysmal/persistent AF undergoing pulmonary vein (PV) CBA using second-generation cryoballoon with simultaneous ECG loop recorder implantation. The duration of follow-up was 12 months, with scheduled visits at 3, 6 and 12 months. RESULTS: 99 patients from 100 completed the 12-month follow-up period. ERAA occurred in 31.3 % of patients. 83.9 % of patients with ERAA also developed late recurrences. The 12-month freedom from AF in patients with ERAA was significantly lower than in those without ERAA (p < 0.0001). Non-paroxysmal AF and longer arrhythmia history were associated with increased risk of both early (HR 3.27; 95 % CI 1.32-8.08; p = 0.010 and HR 1.0147; 95 % CI 1.008-1.086; p = 0.015, respectively) and late recurrences (HR 3.89; 95 % CI 1.67-9.04; p = 0.002 and HR 1.0142; 95 % CI 1.007-1.078; p = 0.019, respectively) of AF. ERAA were another predictor for procedural failure (HR 15.2; 95 % CI (6.42-35.99; p = 0.019). CONCLUSIONS: ERAA occurred in the third of the patients after PV second-generation CBA and are strongly associated with procedural failure. Longer duration of AF history and persistent AF are independent predictors of AF's early and late recurrence.