A pre-existent elevated C-reactive protein is associated with the recurrence of atrial tachyarrhythmias after catheter ablation in patients with atrial fibrillation

Abstract

AIMS: It has been reported that an inflammatory process is involved in the development of atrial fibrillation (AF). In this study, we examined the hypothesis that a pre-existent inflammatory response may enhance the recurrence of AF after catheter ablation (CA). METHODS AND RESULTS: A total of 257 consecutive AF patients undergoing CA were enrolled in this study. The C-reactive protein was assessed by a high-sensitive radio-immunoassay 1 day before the procedure. Of the clinical characteristics, an advanced age, structural heart disease, and the left atrial (LA) diameter were significantly increased when the C-reactive protein level was elevated. Atrial fibrillation occurrences were significantly increased when the C-reactive protein level was elevated. A multivariate analysis demonstrated that an elevated C-reactive protein level [hazard ratio (95% CI); 2.23 (1.04-4.35)], the LA diameter [1.26 (1.10-1.66)], and persistent AF duration [2.13 (1.13-3.79)] were independent factors related to the recurrence of AF after CA. In the procedural findings, burst-inducible AF after pulmonary vein (PV) isolation was significantly increased, and the incidence of AF from the PVs was significantly lower when the C-reactive protein level was elevated. CONCLUSION: An elevated C-reactive protein level was associated with atrial structural and electrical remodelling maintaining AF, and the increased re-entrant atrial substrate might increase the recurrence of AF after the CA procedure.