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High-sensitivity Troponin I and Ablation Effectiveness Quotient after Ablation Index-guided pulmonary vein isolation—markers of arrhythmia recurrence?

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Abstract

Background

There are conflicting data regarding the relationship between high-sensitivity cardiac Troponin I (Hs-cTnI) and the ablation effectiveness quotient (AEQ) with arrhythmia recurrence following atrial fibrillation (AF) ablation. Our goals were to evaluate the impact of the Ablation Index (AI) software on Hs-cTnI and AEQ levels and to assess whether these markers are predictors of arrhythmia recurrence.

Methods

Prospective single-center study of 75 consecutive patients referred for paroxysmal AF ablation from October 2017 to January 2019. Procedural endpoints and 2-year outcomes were assessed and compared to those of 75 propensity score-matched patients submitted to non-AI-guided pulmonary vein isolation (PVI) [control group].

Results

Compared to the control group, patients having AI-guided PVI had lower Hs-cTnI values (1580 [IQR 1180–2140] ng/L vs. 2600 [IQR 1840 – 3900], p < 0.001) and a lower AEQ (0.9 [IQR 0.6–1.2] ng/L/s vs. 1.4 [0.8–1.6] ng/L/s, p < 0.001). After a median follow-up of 26 (IQR 20–32) months, there was a significant reduction in arrhythmia recurrence in the AI group (15% vs. 31%, HR 0.67 [95% CI, 0.32–1.40], p = 0.02). However, neither Hs-cTnI nor AEQ was predictors of arrhythmia recurrence in AI-guided PVI.

Conclusions

The use of the AI software led to reduced levels of Hs-cTnI and lower AEQ in AF patients submitted to PVI. However, none of these markers predicted arrhythmia recurrence.

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Authors and Affiliations

  1. Pacing & Electrophysiology Unit, Cardiology Department, Coimbra’s Hospital and University Center, Morada: Praceta Prof Mota Pinto, 3000-075, Coimbra, Portugal

    Pedro A. Sousa, Luís Puga, Diana Campos, Natália António, Luís Elvas & Lino Gonçalves

  2. Cardiology Department, Hospital da Luz Arrábida, V. N. Gaia, Portugal

    Sérgio Barra

  3. Faculty of Medicine, ICBR, University of Coimbra, Coimbra, Portugal

    Natália António & Lino Gonçalves

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  1. Pedro A. Sousa
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  2. Luís Puga
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  3. Sérgio Barra
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  4. Diana Campos
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  5. Natália António
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  7. Lino Gonçalves
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Correspondence to Pedro A. Sousa.

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Disclosures

P.A.S has received speaker fees from Biosense Webster, Boston Scientific, Medtronic and Abbott. S.B. has received training grants from Biosense Webster and Biotronik. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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Sousa, P.A., Puga, L., Barra, S. et al. High-sensitivity Troponin I and Ablation Effectiveness Quotient after Ablation Index-guided pulmonary vein isolation—markers of arrhythmia recurrence?. J Interv Card Electrophysiol 65, 115–121 (2022). https://doi.org/10.1007/s10840-022-01229-6

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  • DOI: https://doi.org/10.1007/s10840-022-01229-6

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