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Advanced glycation end products predict long-term outcome of catheter ablation in paroxysmal atrial fibrillation

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Abstract

Purpose

Oxidative stress is an important contributor to the etiology of atrial fibrillation (AF). Our aim was to study oxidative stress biomarkers in patients undergoing pulmonary vein isolation (PVI) for paroxysmal AF with radiofrequency catheter ablation and to assess its prognostic value in predicting long-term PVI outcome.

Methods

In this prospective cohort study, we included 62 patients (mean age 55±8 years, 12 females and 50 males) with paroxysmal AF and implanted ECG loop recorders who underwent PVI. Plasmatic concentrations of advanced glycation end-products (AGEs), fructosamine, advanced oxidation protein products, and thiobarbituric-acid reacting substances were measured before PVI. AF burden (percentage of time spent in AF) was continually assessed during the follow-up period (1063±271 days).

Results

Nineteen patients (31%) were defined as optimal responders (oR) with AF burden < 0.5% after PVI. Remaining 43 patients (69%) were defined as sub-optimal responders. Concentration of AGEs was significantly lower in oR by 3.7 g/g (CI: −6.5 to −1.7; P=0.0003). After adjustment for age, sex, BMI, left atrial size, arterial hypertension, and AF burden before PVI, only low concentration of AGEs remained significantly associated with oR (odds ratio: 1.3; P=0.04). AGEs concentration achieved area under the curve of 0.78 for predicting optimal long-term PVI response.

Conclusions

AGEs concentration before PVI was associated with long-term PVI outcome in patients with paroxysmal AF. Further research will show if this biomarker could contribute to optimal patient selection for catheter ablation.

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Change history

  • 22 March 2020

    Springer Nature’s version of this paper was updated to reflect the correct affiliation 2.

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Acknowledgements

We would like to thank Dr. Afzal Sohaib for the valuable help with writing of the manuscript and our collaborators at Comenius University Science Park, Bratislava, Slovakia.

Funding

This work was supported by The Independent research grants of the Ministry of Education, Science, Research and Sport of the Slovak Republic VEGA (grant number 1/0563/21) and KEGA (grant number 030UK-4/2019).

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Authors and Affiliations

  1. National Institute of Cardiovascular Diseases, Pod Krasnou horkou 1, SK-83348, Bratislava, Slovakia

    Allan Bohm, Lubos Urban, Branislav Bezak, Peter Olejnik & Robert Hatala

  2. 3rd Department of Internal Medicine, University Hospital Bratislava, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia

    Allan Bohm

  3. Premedix Academy, Bratislava, Slovakia

    Allan Bohm, Peter Michalek & Tomas Uher

  4. Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia

    Lubomira Tothova

  5. Faculty of Medicine, Comenius University, Bratislava, Slovakia

    Lubomira Tothova, Ljuba Bacharova, Peter Musil, Jan Kyselovic, Peter Michalek, Branislav Bezak & Peter Olejnik

  6. International Laser Center, Bratislava, Slovakia

    Ljuba Bacharova

  7. Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia

    Robert Hatala

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  1. Allan Bohm
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Correspondence to Allan Bohm.

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Bohm, A., Urban, L., Tothova, L. et al. Advanced glycation end products predict long-term outcome of catheter ablation in paroxysmal atrial fibrillation. J Interv Card Electrophysiol 64, 17–25 (2022). https://doi.org/10.1007/s10840-021-00972-6

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