| Background:In recent circumferential pulmonary vein ablation (CPVA) has already became one of the most important treatments of the atrial fribrillation(AF),and its clinical practice is presenting the obvious trend of escalation.However,this treatment still has many items serious insufficient at present stage,the early recurrence of atrial fibrillation (ERAF) ratio can reach as high as 50%after the first CPVA.The majority research limit in clinical facters in order to find the forecast factors of ERAF,regardless of the importance of biochemical markers.With the further development of searching for more cardiovascular markers,we have already accumulated a lot of clinical experiences,especially the NT-proBNP and CRP are of the most focus.It is acknowledged to most of people that NT-proBNP is the maker of heart failure and CRP is the maker of acute inflammation,and some research have proved the relationship between the two makers and AF,but less research has been down on correlation of the two makers with ERAF.Objectives:To probe forecast factors of ERAF.Accurate prediction of recurrence of atrial fibrillation will be beneficial to identify high risk patients with recurrence,reduce the risk of patients and medical costs,is helpful to the treatment decision-making.Methods:To analyze the clinical data of sixty patients with paroxysmal AF and preserved left ventricular systolic function who consequently underwent CPVA from November 2007 to March 2009 in the second xiang ya hospital.Record the characteristics of patients, measure the CRP and NT-proBNP concentrations before and 3 days after cardiac operation respectively.Then,according to the symptoms,12-ECG and Holter ECG of the patients in 3 months,we divided all patients to two groups -the group without ERAF(A) and ERAF group(B).ERAF is defined as an episode of AF or atrial flutter/tachycardia lasting longer than 30 seconds that occurred within the first 3 months of ablation.Results:(1) Single factor analysis showed that P wave dispersion (P=0.011),hypertension(P=0.025),left atrial diameter(P=0.032), the duration time of AF(P=0.023),the NT-proBNP levels before (P=0.012) and after CPVA(P=0.034) were related to ERAF,the baseline NT-proBNP correlated significantly with age,hypertension,left atrial diameter,the duration time of AF.Multivariate analysis indicated that elevation of NT-proBNP(RR 6.63,95%CI 3.54-1.67,P=0.003) and P wave dispersion(RR 5.26,95%CI 5.08-6.48,P=0.035) are predictors of ERAF at 3 months,which can successfully predict ERAF with relatively high sensitivity and specificity.(2) The NT-proBNP level declined after CPVA,especially group A,there was a significant statistical between the two groups(129.95±39.77 vs 75.35±15.63 pg/ml, P＜0.001).(3)The CRP level of group A and group B showed an upward trend after CPVA,but there was no significant statistical difference compared with the level before CPVA(group A 2.70±1.51 vs 3.10±1.85 mg/L,P=0.650;group B 3.00±0.86 vs 3.20±1.03 mg/L,P=0.747).Conclusions:(1) The increasing NT-proBNP before CPVA may represent the highly susceptibility to atrial fibrillation,which can predict the occurrence of ERAF with relatively high sensitivity and specificity.(2) The level of CRP that before and after three days of CPVA can not predict the occurrence of ERAF.(3) P wave dispersion can predict ERAF with the same value as NT-proBNP.
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