Serum MCP-1 Levels Predict Left Atrial Fibrosis And Early Recurrence After Catheter Ablation Of Persistent Atrial Fibrillation

Objectve Atrial fibrillation(AF)is a common type of arrhythmia.Radiofrequency catheter ablation is an important method for reverting sinus rhythm in AF patients.But the success rate of this procedure in persistent AF patients is lower than those with paroxysmal AF.While atrial fibrosis plays an important role in the progression of AF and may lead to AF recurrence.This paper is designed to investigate whether serum monocyte chemoattractant protein-1(MCP-1)levels are associated with the degree of left atrial fibrosis,and the predictive value for early recurrence.Method200 patients with persistent atrial fibrillation who underwent successful catheter ablation from May 2019 to August 2019 were enrolled.Serum MCP-1 levels were measured before the procedure,and the electrical anatomical mapping of left atrium was completed before the ablation in order to evaluate atrial fibrosis.The perioperative data were collected,and early recurrence within 90 days after ablation was assessed by outpatient review and telephone follow-up.Factors related to atrial fibrosis and early recurrence were evaluated by univariate and multivariate analysis.Results The average concentration of serum MCP-1 before ablation in patients with persistent AF was 245.28 ± 16.25 pg/m L,and the average ratio of abnormal voltage area was18.21 ± 9.83%.Posterior wall,anterior wall and septum are the common sites of left atrial fibrosis in patients with persistent AF.Multivariate regression analysis revealed that left atrial fibrosis was correlated with serum MCP-1 concentration and left atrial volume.The 90 days follow-up was completed in all patients,and 51(25.5%)patients experienced recurrence.Patients with early recurrence were older,more likely to have a larger left atrial diameter,serum MCP-1 level,left atrial volume and abnormal voltage ratio(P<0.05).In multivariate regression analysis,MCP-1,left atrial volume and abnormal voltage ratio were significantly associated with early recurrence.MCP-1 demonstrated a predictive value with AUC of 0.671(95% CI 0.593-0.749,P<0.001).The optimal cut-off value was 240.35 pg/m L(sensitivity 88.2%,specificity42.3%).Patients with MCP-1>240.35 pg/m L owned a significant higher early recurrence rate compared with those with MCP-1<240.35 pg/m L(34.4% vs 8.7%,P<0.001).Conclusion Serum MCP-1 levels are effective in predicting left atrial fibrosis and early recurrence after ablation of persistent atrial fibrillation.