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Background  Increasing evidences have suggested that autoantibodies against muscarinic-2 acetylcholine receptor (anti-M 2 -R) may play an important role in the development of atrial fibrillation (AF). Predictive value of pre-procedural anti-M 2 -R for the recurrence of AF after radiofrequency catheter ablation is still unclear.    Methods  Totally 76 AF patients with preserved left ventricular systolic function were prospectively enrolled and subjected to ablation after the detection of serum anti-M 2 -R by enzyme linked immunosorbent assay. These patients were given follow-up examination for one year after ablation. Risk estimation for the recurrence of AF was performed using the univariate and multivariate logistic regression.    Results  In AF group, serum anti-M 2 -R was significantly higher than that in the control group in terms of frequency (40.8% versus 11.7%;  p  < 0.001) and titer (1:116 versus 1:29;  p  < 0.001). Compared with paroxysmal AF patients, persistent AF patients had higher frequency (57.6% versus 27.9%;  p  = 0.009) and titer (1:132 versus 1:94;  p  = 0.012) for autoantibodies. During one-year follow-up examination after ablation, the recurrence of AF was observed in 25 (32.9%) patients. Multivariate analysis showed that pre-procedural serum anti-M 2 -R was an independent predictor for the recurrence of AF at the time point of 12 months after ablation (odds ratio: 4.701; 95% confidence interval: 1.590-13.894;  p  = 0.005).    Conclusions  In AF patients, the frequency and titer of serum anti-M 2 -R were significantly higher than those in the control group with sinus rhythm. Pre-procedural serum anti-M 2 -R was an independent predictor for the recurrence of AF one year after radiofrequency catheter ablation.

journal of translational medicine

Predictive value of pre-procedural autoantibodies against M2-muscarinic acetylcholine receptor for recurrence of atrial fibrillation one year after radiofrequency catheter ablation