Clinical Importance of B-Type Natriuretic Peptide Levels in Sinus Rhythm at 3 Months After Persistent Atrial Fibrillation Ablation.

Background: B-type natriuretic peptide (BNP) levels after ablation have been associated with a risk of arrhythmia recurrence (AR) after atrial fibrillation (AF) ablation. In addition, baseline BNP levels were also predictors of AR after AF ablation. However, previous studies have not been clear about whether sinus rhythm (SR) or AF was present at the time of BNP measurement. In this study, we investigated BNP levels in SR at 1,3 months after persistent AF ablation. Methods: We followed up 178 patients with persistent AF undergoing first-time arrhythmia ablation. BNP levels were measured before 1 and 3 months later after AF ablation in SR. The correlation between AR within 1 year after AF ablation and measured BNP levels was examined. Results: A total of 178 cases (81 males, mean age 69 (60, 74), mean CHA2DS2 Vasc score 2 (0, 4)) with persistent AF were included for ablation. BNP levels before AF ablation were not significantly different between AR and not AR patients. The BNP levels of AR patients were significantly elevated from 1 month to 3 months after the procedure compared with those without (-11.1 pg/mL (-53, 5.7) vs. 17.8 pg/mL (-58.3, 180.5), p < 0.0001). Elevated BNP levels in SR after AF ablation were a significant predictor of AR. Conclusions: Elevated BNP levels in SR 3 months after AF ablation compared with BNP levels 1 month after persistent AF ablation might be a significant prognostic factor in AR.