[Clinical value of N-terminal pro-B-type natriuretic peptide measurement in the follow up of pulmonary vein ablation]

Abstract

Background and objective: N-terminal pro-B-type natriuretic peptide (NT-proBNP) correlates with burden of arrhythmia in atrial fibrillation (AF) patients. Our objective is to validate the usefulness of the measurement of NT-pro-BNP to determine the success of AF ablation in a long term follow up.

Patients and methods: Prospective observational study in which 75 patients with preserved systolic function (81% men; mean age (SD) 52 (9) years; 58.7% paroxysmal) underwent circumferential pulmonary vein isolation. Determination of NT-proBNP baseline and one year after the procedure was performed. The relation between NT-proBNP levels and the success of the procedure is analyzed.

Results: In the follow up 53 (70.7%) patients remained free of recurrences. A>30% decrease of NT-proBNP levels identified success with a sensitivity of 79.2%, specificity 81.8%, positive predictive value 91.3% and negative 62% (area under ROC curve 0.84, 95% confidence interval 73-95.6). This reduction was associated with a decrease in left atrial volume and pressure and the presence of diastolic dysfunction (all P<.05).

Conclusions: The decrease of NT-proBNP levels in patients undergoing AF ablation is useful as a marker of success in the follow up and is associated with hemodynamic improvement.

Keywords: Ablación; Ablation; Atrial fibrillation; Fibrilación auricular; Natriuretic peptides; Péptidos natriuréticos.