Clinical Value of Serum High Sensitive C-reactive Protein and Cardiac Troponin in Predicting Early Ecurrence of Atrial Fibrillation after Catheter Ablation
|Keywords||High-sensitivity C-reactive protein ( hs - CRP ) Cardiac troponin I (cTnI) Atrial fibrillation Radiofrequency ablation|
Background In recent years, the unremitting efforts of several generations, medical science and technology has been rapid development of equipment and technology of radiofrequency catheter ablation contending situation and bring a bright future for the treatment of a variety of complex arrhythmias, especially the treatment of atrial fibrillation (auricular fibrillation AF), sheds some light for the cardiac electrophysiology doctors and patients with atrial fibrillation. In recent years, high-sensitivity C-reactive protein (high sensitive C-reactive protein hs-CRP) and serum troponin I (cardiac troponin cTnI) has become a hot field of study of cardiovascular disease, but hs-CRP and atrial fibrillation after radiofrequency ablation recurrence, and cTnI with atrial fibrillation after radiofrequency ablation of myocardial damage that the study is still small. Atrial fibrillation radiofrequency ablation as a new treatment of atrial fibrillation recurrence rate has been the biggest problem, therefore, to explore the predictors of recurrence of atrial fibrillation after radiofrequency ablation of great significance. Objective To investigate the high-sensitivity C-reactive protein (hs-CRP) changes in the concentration of troponin I (cTnI) in the evaluation of three-dimensional mapping of atrial fibrillation radiofrequency ablation clinical value in the early recurrence. Methods Retrospective analysis of 48 cases of January 2009 to December 2010 in the First People's Hospital of Jining City line three-dimensional mapping system (The EnSite-Array non-contact mapping) under the guidance of radiofrequency ablation in patients with atrial fibrillation. According to the three-dimensional mapping system under the guidance of radiofrequency ablation three months after the patient's symptoms, 12-lead ECG and Holte results indicators are divided into successful treatment group (38 cases) and recurrence group (10 patients), respectively, in the preoperative 12 -24 hours, four hours after application turbidimetric immunoassay repeated measurements of hs-CRP concentration in all patients, and in 12 to 24 hours before surgery, after 4 hours Bo fitness-the Triage dry-type rapid quantitative myocardial infarction / heart failure diagnostic (Biosite) repeated measurements of troponin I concentration. Cardiac troponin I (cTnI) normal range lt; 0.40ng/mL,. Early relapse was defined: within three months after the occurrence of symptomatic atrial fibrillation or recorded by the duration of GT; 10min asymptomatic atrial fibrillation. Results were followed up for ≥ 3 months, a total of 10 cases of recurrence in 48 patients, of which 38 cases were successful group of paroxysmal atrial fibrillation in 28 cases, 10 cases of persistent atrial fibrillation, paroxysmal atrial fibrillation in 10 patients with relapsed group 6 cases, 4 cases of persistent atrial fibrillation. Successful group and the recurrence group in age, sex, medical history, along with the disease, ejection fraction, type of AF, left atrial size, radiofrequency ablation discharge time, the average ablation power, postoperative medication difference was not statistically significant (p gt; 05) are shown in Table 1, Figure 1, Figure 2. (1) in patients with atrial fibrillation cardioversion to sinus rhythm plasma hs-CRP level (21.39 ± 7.27mg / L) and troponin I levels (1.82 ± 0.53ng/ml) compared three-dimensional mapping of atrial fibrillation radiofrequency ablation radiofrequency ablation plasma hs-CRP levels (3.23 ± 1.13mg / L) and troponin I levels (0.03 ± 0.01ng/ml) were significantly increased, there was a significant difference (p lt; 0.001) are shown in Table 2 , Figure 3, Figure 4. (2) the success of the group (A) postoperative high-sensitivity C-reactive protein (hs-CRP) changes in the value (12.37 ± 4.37mg/ml) and recurrence group (B) postoperative high-sensitivity C-reactive protein (hs-CRP) changes in the value (40.28 ± 13.96mg/ml), both statistically significant difference (p lt; 0.001), see Table 3, Figure 5. (3) the success group (A group) postoperative troponin I (cTnI) the concentration value (1.79 ± 0.53ng/ml) and recurrence group (B) postoperative troponin I (cTnI) concentration (1.83 ± 0.55ng/ml) compared, there was no statistically significant difference (p gt; 0.05), are shown in Table 4, Figure 6. (4) the CRP concentration value of early postoperative atrial fibrillation radiofrequency ablation success or recurrence rate is closely related to R = 0.846, p lt; 0.001, there was significant correlation. Conclusion The three-dimensional mapping system under the guidance of atrial fibrillation RF ablation in patients with myocardial are subject to varying degrees of damage, and early postoperative recurrence rate (after 3 months), there are some. hs-CRP associated with atrial fibrillation are closely related, may be involved in the occurrence and development of atrial fibrillation, and hs-CRP concentration in the evaluation of atrial fibrillation ablation on the predictive value of early recurrence, and the concentration of cardiac troponin I (cTnI ) had no significant change in the evaluation of patients with atrial fibrillation recurrence rate value.