Safety of radiofrequency ablation for reducing inflammatory cytokine levels and the left atrial diameter in patients with atrial fibrillation

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Abstract

Objective

To investigate the safety of radiofrequency ablation for reducing inflammatory cytokines and the left atrial diameter in patients with atrial fibrillation (AF).

Methods

A total of 200 patients with AF who were admitted to our hospital from December 2015 to April 2017 were included in this prospective analysis. Fifty patients were treated with conventional AF medication alone (AF medication group) and 50 patients received radiofrequency ablation (RFA) on the basis of conventional medication (RFA group).

Results

After treatment, the AF medication group showed significantly higher levels of high-sensitivity C-reactive protein, interleukin-6, carboxyterminal propeptide of type-I procollagen, procollagen type III N-terminal propeptide, and matrix metallopeptidase-9 than the RFA group. The AF medication group had a significantly lower activated partial thromboplastin time, thrombin time, and prothrombin time than the RFA group. A significantly smaller left atrial diameter was observed in both groups after treatment, but this decrease was more pronounced in the RFA group than in the AF medication group. The total treatment efficacy rate was significantly lower in the AF medication group than in the RFA group.

Conclusions

For patients with AF, RFA leads to a lower incidence of inflammatory responses, faster recovery of cardiac function, and good safety.

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Most cited references 25

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Interleukin-17A contributes to the development of post-operative atrial fibrillation by regulating inflammation and fibrosis in rats with sterile pericarditis

XIAO-XING FU, Ning Zhao, Qian Dong … (2015)

Post-operative atrial fibrillation (AF) remains a common cause of morbidity. Increasing evidence indicates that inflammation and atrial fibrosis contribute to the pathogenesis of this condition. Interleukin (IL)-17A, a potent pro-inflammatory cytokine, has been implicated in the development of a number of cardiovascular diseases. However, its role in post-operative AF remains unknown. In the present study, sterile pericarditis (SP) was induced in rats by the epicardial application of sterile talc. AF was induced by transesophageal burst pacing. Western blot analysis was applied to quantify the expression of IL-17A. Quantitative PCR was used to detect the mRNA expression of IL-17A, IL-6, IL-1β, transforming growth factor-β1 (TGF-β1), collagen type 1 (Col-1), collagen type 3 (Col-3) and α-smooth muscle actin (α-SMA). Gelatin zymography and reverse gelatin zymography were used to quantify the levels of matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs). Histological analyses were performed to determine the extent of tissue inflammation and fibrosis. The rats with SP presented with a shorter refractoriness, a higher incidence and duration of AF, an enhanced susceptibility to developing AF, increased mRNA levels of AF-related pro-inflammatory cytokines (IL-6, IL-1β and TGF-β1), as well as marked atrial inflammation and fibrosis. The atrial IL-17A levels were elevated and correlated with the probability of developing AF. Treatment with anti-IL-17A monoclonal antibody decreased the levels of atrial IL-17A, prolonged refraction and markedly suppressed the development of AF. Simultaneously, inflammation and fibrosis were alleviated, which was further demonstrated by a decreased expression of AF-related pro-inflammatory cytokines, a down-regulation in fibrosis-related mRNA expression (Col-1, Col-3 and α-SMA) and by the decreased activity of MMP-2/9 and TIMPs. Thus, the findings of our study indicate that IL-17A may play a pathogenic role in post-operative AF by inducing inflammation and fibrosis in rats with SP.

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The association between atrial fibrillation and sudden cardiac death: the relevance of heart failure.

Kyndaron Reinier, Eloi Marijon, Audrey Uy-Evanado … (2014)

The purpose of this study was to evaluate the role of congestive heart failure (CHF) in the association between atrial fibrillation (AF) and sudden cardiac death (SCD).

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Persistent atrial fibrillation: A systematic review and meta-analysis of invasive strategies

Wouter R Berger, Eva R. Meulendijks, Jacqueline Limpens … (2018)

Persistent atrial fibrillation (AF) is associated with higher stroke and mortality risk than paroxysmal AF (pAF). Outcomes of catheter or surgical ablation are worse in patients with persistent AF than in pAF, and the optimal invasive rhythm control strategy has not been established.

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Author and article information

Journal

Journal ID (nlm-ta): J Int Med Res

Journal ID (iso-abbrev): J. Int. Med. Res

Journal ID (publisher-id): IMR

Journal ID (hwp): spimr

Title: The Journal of International Medical Research

Publisher: SAGE Publications (Sage UK: London, England )

ISSN (Print): 0300-0605

ISSN (Electronic): 1473-2300

Publication date (Electronic): 10 September 2020

Publication date Collection: September 2020

Volume: 48

Issue: 9

Electronic Location Identifier: 0300060520949760

Affiliations

[1-0300060520949760]Department of Cardiology, People’s Hospital of Ganzhou, Jiangxi, China

Author notes

[*]

These authors contributed equally to this work.

[*]Zhihong Xie, Department of Cardiology, People’s Hospital of Ganzhou, No. 16 Meiguan Avenue, Zhanggong District, Ganzhou, Jiangxi 341000, China. Email: zhihongxie0905@ 123456163.com

Author information

Zhihong Xie https://orcid.org/0000-0001-8364-3412

Article

Publisher ID: 10.1177_0300060520949760

DOI: 10.1177/0300060520949760

PMC ID: 7488899

SO-VID: 8f4c49fc-acb4-408f-866a-2c5207e08d9d

License:

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 18 November 2019

Date accepted : 23 July 2020

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Keywords: atrial fibrillation,radiofrequency ablation,safety,cytokine,left atrial diameter,inflammatory response,thrombin time

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Keywords: atrial fibrillation, radiofrequency ablation, safety, cytokine, left atrial diameter, inflammatory response, thrombin time

Safety of radiofrequency ablation for reducing inflammatory cytokine levels and the left atrial diameter in patients with atrial fibrillation

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Abstract

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International Journal of Medicine and Medical Research

Most cited references 25

Interleukin-17A contributes to the development of post-operative atrial fibrillation by regulating inflammation and fibrosis in rats with sterile pericarditis

The association between atrial fibrillation and sudden cardiac death: the relevance of heart failure.

Persistent atrial fibrillation: A systematic review and meta-analysis of invasive strategies

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