N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation

  • Eivind SolheimEmail author
  • Morten Kristian Off
  • Per Ivar Hoff
  • Alessandro De Bortoli
  • Peter Schuster
  • Ole-Jørgen Ohm
  • Jian Chen



We investigated the relationship between arrhythmia burden, left atrial volume (LAV) and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) at baseline and after long-term follow-up of atrial fibrillation (AF) ablation.


We studied 38 patients (23 paroxysmal, 6 women, mean age 56 ± 11) scheduled for AF ablation. LAV was calculated on the basis of computed tomography images at baseline and long-term follow-up, and arrhythmia burden was graded from self-reported frequency and duration of AF episodes.


After a mean period of 22 ± 5 months, 28/38 patients (11/15 persistent) were free from AF recurrence. At baseline there were no differences in mean LAV (125 vs. 130 cm3, p = 0.7) or median NT-pro-BNP (33.5 vs. 29.5 pmol/L, p = 0.9) between patients whose ablation had been successful or otherwise. At long-term follow-up, there was a marked decrease in LAV (105 vs. 134 cm3, p < 0.05) and level of NT-pro-BNP (7 vs. 17.5 pmol/L, p < 0.05) in the successful ablation patients. NT-pro-BNP correlated with LAV both at baseline (r = 0.71, p < 0.001) and at follow-up (r = 0.57, p < 0.001). Arrhythmia burden correlated with both NT-pro-BNP (r = 0.47, p < 0.01) and LAV (r = 0.52, p < 0.01). A decrease in NT-pro-BNP at follow-up of >25% of baseline value had a specificity of 0.89 and a sensitivity of 0.6 (receiver operator characteristics, accuracy 0.82) for ablation success.


NT-pro-BNP correlates with LAV and arrhythmia burden in AF patients and both NT-pro-BNP and LAV decrease significantly after successful ablation. A decrease in NT-pro-BNP of >25% from the baseline value could be useful as a marker of ablation success.


Atrial fibrillation Ablation Natriuretic peptide Atrial volume Arrhytmia burden 



This study was supported by a grant from the Norwegian Foundation for Health and Rehabilitation.

Conflict of interest

Chen and Solheim received consultant fees from St. Jude Medical, and Peter Schuster was a recipient of Nordic electrophysiological research grant from Biosense Webster.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Eivind Solheim
    • 1
    • 2
    Email author
  • Morten Kristian Off
    • 2
  • Per Ivar Hoff
    • 2
  • Alessandro De Bortoli
    • 1
  • Peter Schuster
    • 1
    • 2
  • Ole-Jørgen Ohm
    • 1
  • Jian Chen
    • 1
    • 2
  1. 1.Institute of MedicineUniversity of BergenBergenNorway
  2. 2.Department of Heart DiseaseHaukeland University HospitalBergenNorway

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