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Declines in serum uric acid level after catheter ablation of atrial fibrillation

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Abstract

Background

Few studies have examined whether catheter ablation for AF patients improves biomarkers other than serum levels of brain natriuretic peptide (BNP) and renal function. This study was to explore whether catheter ablation for atrial fibrillation (AF) patients affects uric acid (UA), glucose and lipid metabolism.

Methods and results

A total of 206 patients (66.6 ± 10.4 years; 132 men) who underwent initial AF ablation without changes to oral medications were included. Baseline BNP and UA levels significantly decreased at 1 year after ablation (p < 0.05 each). Changes in UA level correlated significantly with pre-procedural UA level (r = 0.57). In multivariable logistic regression modeling, pre-procedural UA level, persistent AF, and hemoglobin A1c (p < 0.05 each) were independent predictors of post-procedural UA level decline. Significant improvements in both persistent and paroxysmal AF patients were identified, and the magnitude of post-procedural serum UA level decline after ablation (ΔUA) was significantly greater in patients with persistent AF (0.8 ± 1.0 mg/dl) than in those with paroxysmal AF (0.2 ± 0.8 mg/dl, p < 0.001). Of the 48 patients with high UA level before procedure, 28 patients showed improvement in UA level to normal range.

Conclusions

Catheter ablation for AF patients significantly improved serum UA levels without obvious influences of heart failure, renal function, or inflammation, suggesting that AF ablation may be effective for AF patients with hyperuricemia.

Trial registration The study was approved by the Research Ethics Committee of University of Fukui (no. 20210132) and clinical trial registration (UMIN000044669).

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Abbreviations

ACEI:

Angiotensin-converting-enzyme inhibitor

AF:

Atrial fibrillation

ARB:

Angiotensin 2 receptor blocker

BNP:

Brain natriuretic peptide

CFAEs:

Continuous fractionated atrial electrograms

CI:

Confidence interval

hs-CRP:

High-sensitivity C-reactive protein

eGFR:

Estimated glomerular filtration rate

HbA1c:

Hemoglobin A1c

HDL-cholesterol:

High-density lipoprotein cholesterol

LDL-cholesterol:

Low-density lipoprotein cholesterol

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

OR:

Odds ratio

PV:

Pulmonary vein

UA:

Uric acid

XO:

Xanthine oxidase

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Funding

Daiichi Sankyo Company,Biotronik,Bristol-Myers Squibb,Boehringer Ingelheim,Bayer,ALVAUS,Novartis Pharma,Ono Pharmaceutical,Takeda Pharmaceutical Company,DVx.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan

    Daisetsu Aoyama, Hiroyasu Uzui, Takayuki Sekihara, Tomoya Eguchi, Kanae Hasegawa, Toshihiko Tsuji, Tatsuhiro Kataoka, Moeko Nagao, Shota Kakehashi, Moe Mukai, Takayoshi Aiki, Junya Yamaguchi, Yuichiro Shiomi, Naoto Tama, Yoshitomo Fukuoka, Kentaro Ishida & Hiroshi Tada

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  1. Daisetsu Aoyama
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  2. Hiroyasu Uzui
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Corresponding author

Correspondence to Daisetsu Aoyama.

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Conflicts of interest

Hiroshi Tada is a member of Circulation Journal’s editorial team and received honoraria (lecture fees) from Daiichi-Sankyo Co., Ltd., Biotronik Japan, Inc., Bristol-Myers Squibb, and Boehringer Ingelheim and grants from Bayer Yakuhin, Ltd., Japan, Boehringer Ingelheim Japan, ALVAUS Co., Ltd., Novartis Pharmaceuticals Japan, ONO PHARMACEUTICAL CO., LTD, and Takeda Pharmaceutical Company, Ltd. Daisetsu Aoyama, Moe Mukai, and Shota Kakehashi belong to endowed department by Biotronik Japan, Inc., DVx Inc., ALVAUS Co., Ltd. No other authors have any conflicts of interest to disclose.

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Aoyama, D., Uzui, H., Sekihara, T. et al. Declines in serum uric acid level after catheter ablation of atrial fibrillation. Heart Vessels 37, 2049–2058 (2022). https://doi.org/10.1007/s00380-022-02108-w

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  • DOI: https://doi.org/10.1007/s00380-022-02108-w

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