Abstract 12632: The Predictive Value of Pre-Procedural Autoantibodies Against M2 Muscarinic Acetylcholine Receptor For the Short-Term Recurrence of Atrial Fibrillation After Radiofrequency Catheter Ablaton
Backgroud: Increasing evidence has suggested that autoantibodies against M2 muscarinic acetylcholine receptor (M2-AAB) may play a role in the development of atrial fibrillation (AF).
Objectives: The objective of this study was to assess the predictive value of pre-procedural levels of serum M2-AAB for the short-term (six-month) recurrence of AF after radiofrequency catheter ablation.
Methods: Sixty consecutive patients with AF (paroxysmal n=43, persistent n=17) and preserved left ventricular systolic function (left ventricular ejection fraction, LVEF>60%) were prospectively enrolled in this study. All of the enrolled AF patients underwent catheter ablation after a measurement of serum levels of M2-AAB by enzyme linked immunosorbent assay (ELISA). Patients were followed up for 6 months after catheter ablation. Estimations of risk were performed using the Cox proportional hazard models by univariate and multivariate analysis.
Results: Patients with AF recurrence at 6 months had more persistent AF (P=0.005), a higher left atrial (LA) volume index (P=0.009), higher plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels (P=0.012) and higher serum levels of M2-AAB (frequency: 66.7% vs. 15.6%, P=0.001; titer: 1:43.20 vs. 1:22.08, P=0.001, respectively), when compared with patients with sinus rhythm restoration. The titers of serum M2-AAB correlated significantly with LA volume index and plasma NT-proBNP levels (Spearman correlation coefficients were 0.504 and 0.502, P<0.001, respectively). Multivariable analysis adjusted by persistent AF, LA size and plasma NT-proBNP levels indicated that pre-procedural titer of serum M2-AAB was an independent predictor of recurrence of AF at 6 months after catheter ablation (OR=2.339,95% confidence interval 1.509-3.625,P<0.001).
Conclusions: In AF patients with preserved left ventricular systolic function, the pre-procedural titer of serum M2-AAB was an independent predictor of recurrence of AF at 6 months after radiofrequency catheter ablation.
- © 2011 by American Heart Association, Inc.