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Comparative Determination and Monitoring of Biomarkers of Necrosis and Myocardial Remodeling between Radiofrequency Ablation and Cryoablation
Author(s) -
HERNÁNDEZROMERO DIANA,
MARÍN FRANCISCO,
ROLDÁN VANESSA,
PEÑAFIEL PABLO,
VILCHEZ JUAN ANTONIO,
ORENESPIÑERO ESTEBAN,
GINER JOSÉ ANTONIO,
VALDÉS MARIANO,
GARCÍAALBEROLA ARCADIO
Publication year - 2013
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12017
Subject(s) - cryoablation , medicine , radiofrequency ablation , ablation , troponin i , necrosis , cardiology , atrial fibrillation , inflammation , myocardial infarction
Background Biomarkers of necrosis and inflammation have been found raised after radiofrequency ablation (RF). There is scarce information on biomarkers’ behavior after cryoablation. Our aim was to study biomarkers of necrosis, inflammation, and interstitial remodeling after two different approaches: RF versus cryoablation. Methods We studied 22 consecutive patients with atrial flutter who underwent RF (10) or cryoablation (12). All patients underwent electrophysiological study and subsequent ablation. Peripheral samples were collected before the procedure, immediately after, the following day, 3 days, 1 week, 1 month, and 2 months after ablation. Samples were assayed for biomarkers of inflammation (high sensitive C‐reactive protein [hs‐CRP]) and tissue remodeling (C‐propeptide of type I procollagen [CICP], matrix metalloproteinase 2 [MMP‐2], matrix metalloproteinase 9 [MMP‐9], and metallopeptidase inhibitor 1 [TIMP‐1]). We also determined biomarkers of tissue necrosis (creatine kinase [CK], its MB isoenzyme, cardiac troponin I [TnI], and troponin T (TnT)] in samples obtained immediately after ablation, 6 hours postablation, and 12 hours postablation. Results Bidirectional isthmus block was achieved in all patients. We found significantly higher levels of CK, CK‐MB, and TnI after cryoablation compared to RF ablation for all timing samples. These necrosis biomarkers showed significant differences depending on the time (all P < 0.001), and the interaction between the time and the used ablation approach (P = 0.005, P < 0.001, and P < 0.001, respectively). For patients who undergoing RF ablation, MMP‐2 showed the greatest changes depending on the interaction between time and number of applications (P = 0.041), whereas for patients who undergoing cryoablation, CK was the most relevant biomarker depending on the interaction between time and number of applications (P = 0.006). Conclusions We show higher levels of necrosis and myocardial injury biomarker after cryoablation versus RF. However, we found higher remodeling processes after RF. Our data support previous publications showing different lesion formation in cryoablation and RF. (PACE 2013; 36:31–36)