The Effect Of High-sensitive Cardiac Troponin T On Recurrence Of Atrial Fibrillation After Catheter Ablation

Objective:To determine the change of High-sensitive Cardiac Troponin T(hs-TNT)before and 6 hours and the first day after catheter ablation for atrial fibrillation(AF),our aim is to evaluate the significance of hs-TNT on recurrence of atrial fibrillation after catheter ablation.Methods: A total of 109 patients who hospitalized in the Department of Cardiology in the First Affiliated Hospital of China Medical University after catheter ablation for AF were selected from February 2017 to November 2017.Serum hs-TNT were collected before and after 6 hours and the first day of AF ablation for all the patients,which was detected by Roche Electrochemiluminescence immunoassay.The presence of atrial fibrillation was evaluated based on 12-lead ECG recordings and 24 h ambulatory monitoring(1,3,6months after the procedure).Recurrence of atrial fibrillation was identified from ECG documentation of atrial tachycardia lasting ≥30s on a 12-lead ECG or holter monitor recording after a 3-month blanking period from the procedure,which was divided into the groups of recurrence or no recurrence.The difference of baseline data between the two groups was compared and the level of hs-TNT was also evaluated.Meanwhile,multivariate logistic regression was used to evaluate independent risk factors of AF recurrence.Results:1.The baseline data revealed that prior stroke,CHA2DS2-VASc score,left atrial diameter were greater in the group of AF recurrence(P<0.05),which showed statistical significance.Other factors were no difference between the two groups.2.Serum hs-TNT before AF ablation was higher in the group of AF recurrence than the non-recurrence(P<0.05).There was no difference between the two groups about serum hs-TNT after 6 hours and the first day of AF ablation.3.The level of serum hs-TNT before AF ablation was higher in the group of AF recurrence with interventional therapy of radiofrequency ablation,but there was no statistical significance between the two groups.No difference about hs-TNT after 6 hours and the first day of AF ablation was found in the the gruop of recurrence or no recurrence of AF with interventional therapy of radiofrequency ablation.4.No difference about hs-TNT before and after 6 hours and the first day of AF ablation was found in the thegruop of recurrence or no recurrence of AF with interventional therapy of cryoballoon ablation.5.The correlation between hs-TNT level and echocardiography index and biochemical indicators was analyzed,and the results showed that the level of preoperative hs-TNT was positively correlated with hs-CRP and CHA2DSA-VASc(r=0.204,P=0.033;r=0.288,P=0.002),and the level of hs-TNT after 6 hours and the first day of AF ablation and LAD were negatively correlated(r=-0.317,P=0.001;r=-0.280,P=0.003).6.The results of multivariate logistic regressive analysis showed that increased hs-TNT before AF ablation and enlargement of left atrial diameter were independent risk factors of AF recurrence.Conclusion: 1.No correlation was found between the level of hs-TNT after double ablation therapies and recurrence of AF.2.The level of baseline hs-TNT and enlargement of left atrial diameter had a significant influence on the recurrence of AF after ablation.