Impact of the ablation technique on release of the neuronal injury marker S100B during pulmonary vein isolation

TY - JOUR

T1 - Impact of the ablation technique on release of the neuronal injury marker S100B during pulmonary vein isolation

AU - Scherschel, Katharina

AU - Hedenus, Katja

AU - Jungen, Christiane

AU - Münkler, Paula

AU - Willems, Stephan

AU - Anwar, Omar

AU - Klatt, Niklas

AU - Eickholt, Christian

AU - Meyer, Christian

N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2020/10/1

Y1 - 2020/10/1

N2 - AIMS: S100B, a well-known damage-associated molecular pattern protein is released acutely by central and peripheral nerves and upon concomitant denervation in pulmonary vein isolation (PVI). We aimed to investigate whether the ablation technique used for PVI impacts S100B release in patients with paroxysmal atrial fibrillation (AF).METHODS AND RESULTS: The study population consisted of 73 consecutive patients (age: 62.7 ± 10.9 years, 54.8% males) undergoing first-time PVI with either radiofrequency (RF; n = 30) or cryoballoon (CB; n = 43) for paroxysmal AF. S100B determined from venous plasma samples taken immediately before and after PVI increased from 33.5 ± 1.8 to 91.1 ± 5.3 pg/mL (P < 0.0001). S100B release in patients undergoing CB-PVI was 3.9 times higher compared to patients with RF-PVI (ΔS100B: 21.1 ± 2.7 vs. 83.1 ± 5.2  pg/mL, P < 0.0001). During a mean follow-up of 314 ± 186 days, AF recurrences were observed in 18/71 (25.4%) patients (RF-PVI: n = 9/28, CB-PVI: n = 9/43). Univariate Cox regression analysis indicated that an increase in S100B was associated with higher freedom from AF in follow-up (hazard ratio per 10  pg/mL release of S100B: 0.83; 95% confidence interval: 0.72-0.95; P = 0.007).CONCLUSION: The ablation technique used for PVI has an impact on the release of S100B, a well-established biomarker for neural damage.

AB - AIMS: S100B, a well-known damage-associated molecular pattern protein is released acutely by central and peripheral nerves and upon concomitant denervation in pulmonary vein isolation (PVI). We aimed to investigate whether the ablation technique used for PVI impacts S100B release in patients with paroxysmal atrial fibrillation (AF).METHODS AND RESULTS: The study population consisted of 73 consecutive patients (age: 62.7 ± 10.9 years, 54.8% males) undergoing first-time PVI with either radiofrequency (RF; n = 30) or cryoballoon (CB; n = 43) for paroxysmal AF. S100B determined from venous plasma samples taken immediately before and after PVI increased from 33.5 ± 1.8 to 91.1 ± 5.3 pg/mL (P < 0.0001). S100B release in patients undergoing CB-PVI was 3.9 times higher compared to patients with RF-PVI (ΔS100B: 21.1 ± 2.7 vs. 83.1 ± 5.2  pg/mL, P < 0.0001). During a mean follow-up of 314 ± 186 days, AF recurrences were observed in 18/71 (25.4%) patients (RF-PVI: n = 9/28, CB-PVI: n = 9/43). Univariate Cox regression analysis indicated that an increase in S100B was associated with higher freedom from AF in follow-up (hazard ratio per 10  pg/mL release of S100B: 0.83; 95% confidence interval: 0.72-0.95; P = 0.007).CONCLUSION: The ablation technique used for PVI has an impact on the release of S100B, a well-established biomarker for neural damage.

KW - Ablation Techniques

KW - Aged

KW - Anticoagulants

KW - Atrial Fibrillation/diagnosis

KW - Biomarkers

KW - Catheter Ablation/adverse effects

KW - Cryosurgery/adverse effects

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Pulmonary Veins/surgery

KW - S100 Calcium Binding Protein beta Subunit

KW - Treatment Outcome

U2 - 10.1093/europace/euaa159

DO - 10.1093/europace/euaa159

M3 - SCORING: Journal article

C2 - 32830253

VL - 22

SP - 1502

EP - 1508

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 10

ER -