Abstract 19260: Predictive Value of Circulating Biomarkers of Collagen Metabolism Following Catheter Ablation of Atrial Fibrillation

Introduction: Myocardial fibrosis plays an important role in the pathogenesis of atrial fibrillation (AF). However, catheter ablation may eliminate AF sources but also increases fibrosis. We aimed to assess the predictive value of circulating biomarkers of collagen metabolism following AF catheter ablation. Methods: Serum levels (ELISA) of biomarkers of collagen metabolism were analyzed in patients undergoing AF ablation (62 paroxysmal, 67 persistent) at baseline and 12 months after ablation. Biomarkers levels in 20 patients in sinus rhythm were also evaluated to establish the normal values. Results: Before ablation, there was a direct linear correlation between PICP (carboxy-terminal propeptide of procollagen type I) levels and left atrial diameter for the overall sample (p=0.006). PICP levels at baseline were lower in paroxysmal AF patients with vs. without AF recurrences following ablation (68.30 ± 9.66μg/l vs 90.72 ± 3.78μg/l; p=0.017). At 12 months following ablation of paroxysmal patients, PICP levels significantly increased only in patients with AF recurrences (21.74μg/l vs -0.12 μg/l, Figure). There were no significant changes in biomarkers levels in persistent AF patients at baseline or during follow-up. Conclusions: Progressive increase of PICP levels following catheter ablation of AF is related with arrhythmia recurrence in paroxysmal AF patients. This result suggests that ablation may increase collagen turnover in non-responders paroxysmal AF patients.