Disclosures: Dr. Hernández-Romero holds a “Sara Borrell” postdoctoral position funded by the Instituto de Salud Carlos III. Dr. Orenes-Piñero holds a postdoctoral position funded by the Fundación para la Formación e Investigación Sanitarias de la Región de Murcia (FFIS). JA Vílchez holds a “Rio-Hortega” research-training position funded by the Instituto de Salud Carlos III.
Comparative Determination and Monitoring of Biomarkers of Necrosis and Myocardial Remodeling between Radiofrequency Ablation and Cryoablation
Article first published online: 18 OCT 2012
©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 36, Issue 1, pages 31–36, January 2013
How to Cite
HERNÁNDEZ-ROMERO, D., MARÍN, F., ROLDÁN, V., PEÑAFIEL, P., VILCHEZ, J. A., ORENES-PIÑERO, E., GINER, J. A., VALDÉS, M. and GARCÍA-ALBEROLA, A. (2013), Comparative Determination and Monitoring of Biomarkers of Necrosis and Myocardial Remodeling between Radiofrequency Ablation and Cryoablation. Pacing and Clinical Electrophysiology, 36: 31–36. doi: 10.1111/pace.12017
- Issue published online: 9 JAN 2013
- Article first published online: 18 OCT 2012
- Manuscript Accepted: 15 AUG 2012
- Manuscript Revised: 28 JUN 2012
- Manuscript Received: 23 MAR 2012
- Roche Diagnostics
- RF ablation;
- myocardial remodeling
Biomarkers of necrosis and inflammation have been found raised after radiofrequency ablation (RF). There is scarce information on biomarkers’ behavior after cryoablation. Our aim was to study biomarkers of necrosis, inflammation, and interstitial remodeling after two different approaches: RF versus cryoablation.
We studied 22 consecutive patients with atrial flutter who underwent RF (10) or cryoablation (12). All patients underwent electrophysiological study and subsequent ablation. Peripheral samples were collected before the procedure, immediately after, the following day, 3 days, 1 week, 1 month, and 2 months after ablation. Samples were assayed for biomarkers of inflammation (high sensitive C-reactive protein [hs-CRP]) and tissue remodeling (C-propeptide of type I procollagen [CICP], matrix metalloproteinase 2 [MMP-2], matrix metalloproteinase 9 [MMP-9], and metallopeptidase inhibitor 1 [TIMP-1]). We also determined biomarkers of tissue necrosis (creatine kinase [CK], its MB isoenzyme, cardiac troponin I [TnI], and troponin T (TnT)] in samples obtained immediately after ablation, 6 hours postablation, and 12 hours postablation.
Bidirectional isthmus block was achieved in all patients. We found significantly higher levels of CK, CK-MB, and TnI after cryoablation compared to RF ablation for all timing samples. These necrosis biomarkers showed significant differences depending on the time (all P < 0.001), and the interaction between the time and the used ablation approach (P = 0.005, P < 0.001, and P < 0.001, respectively). For patients who undergoing RF ablation, MMP-2 showed the greatest changes depending on the interaction between time and number of applications (P = 0.041), whereas for patients who undergoing cryoablation, CK was the most relevant biomarker depending on the interaction between time and number of applications (P = 0.006).
We show higher levels of necrosis and myocardial injury biomarker after cryoablation versus RF. However, we found higher remodeling processes after RF. Our data support previous publications showing different lesion formation in cryoablation and RF.
(PACE 2013; 36:31–36)