• Jayasree Pillarisetti, Namratha Reddy, Mazda Biria, Kay Ryschon, Darbhamulla Nagarajan, Caroline Murray, Donita Atkins, Sudharani Bommana, Madhu Yeruva Reddy, Luigi DiBiase, Rhea Pimentel, Loren Berenbom, Buddhadeb Dawn, Andrea Natale, and Dhanunjaya Lakkireddy.
• Division of Cardiology-KU Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, KS, 66195, USA.
• J Interv Card Electrophysiol. 2014 Aug 1; 40 (2): 161-8.

BackgroundPre- and postablation atrial fibrillation (AF) brain natriuretic peptide (BNP) levels were shown to predict increased recurrence of AF following ablation.ObjectiveOur objective was to assess whether elevated BNP levels merely represent the presence of AF at the time of measurement or indeed the true recurrence of AF.Methods And ResultsIn a prospective study of 88 patients undergoing AF ablation, BNP levels were measured immediately before, after, 24 h, and 4-6 months postablation. BNP levels were stratified by presenting rhythm and ventricular rate at the time of measurement. Median BNP level preablation was higher in patients presenting in AF compared to sinus rhythm (SR) (54(44-79) pg/ml vs. 30(18-47) pg/ml, p < 0.001). Postablation restoration of SR in patients presenting in AF reduced median BNP levels from 54(44-79) pg/ml to 40(37-51) pg/ml, (p < 0.001). However, no change was noted in patients who presented in and maintained SR throughout the procedure (30(18-47) pg/ml to 27(16-40) pg/ml, p = 0.270). At 4-6 months, BNP measured in patients in SR was not significantly different from postablation BNP (35(22-53) pg/ml vs. 38(20-52) pg/ml, p = 0.656), although 35% of them had AF recurrence in 1-year follow-up. Median BNP level measured in five patients while in atrial arrhythmia was elevated compared to postablation BNP (464(421-464) pg/ml to 37(36-37) pg/ml, p = 0.043). BNP levels and ventricular rates are positively correlated at all times pre- and postablation.ConclusionsBNP level rises acutely during AF and with rapid ventricular rates. BNP level seems to be a function of atrial rhythm and ventricular rate rather than short- or long-term predictor of AF ablation success.

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