ArticleOpen heart2025
Integrating pre-ablation and post-ablation B-type natriuretic peptide to identify high-risk population for long-term adverse events and arrhythmic recurrence in persistent atrial fibrillation.
Article in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Predictors of atrial fibrillation recurrence after catheter ablation: a systematic review.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026Review
- Association of cardiovascular-kidney-metabolic burden with recurrence after first ablation in patients with persistent atrial fibrillation.BMC cardiovascular disorders · 2026Article
- Integrated biomarkers and cardiac phenotypes associated with atrial fibrillation: evidence from real-world hospital data.Frontiers in cardiovascular medicine · 2026Article
- Comparison of post ablation left atrial volume index versus left atrial reverse remodeling for prognostic events in persistent atrial fibrillation.Scientific reports · 2025Article
- Renal and Cardiovascular Outcomes of IABP-Assisted PCI in Renal Dysfunction: A Propensity-Matched Study and MACEs Prediction Model Development.International journal of general medicine · 2025Article
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Authors and funding
10 authors.
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Abstract
backgroundPre-procedural and post-procedural plasma B-type natriuretic peptide (BNP) levels can predict rhythm outcomes after catheter ablation for atrial fibrillation (AF). However, the significance of long-term events remains unclear. Therefore, this study aimed to investigate the significance of integrating pre-ablation and post-ablation BNP levels on major adverse cardiovascular events (MACE) and arrhythmic recurrence in patients with persistent AF undergoing catheter ablation.
methodsWe analysed 392 patients who underwent first catheter ablation. Patients were stratified into four subgroups based on pre-ablation plasma BNP level and its relative change after ablation (ΔBNP) using their respective median values (pre-ablation BNP: 148.0 pg/mL, ΔBNP: -52.6%): Low-Low (pre-ablation<148.0 pg/mL, ΔBNP<-52.6%), Low-High (pre-ablation<148.0 pg/mL, ΔBNP≥-52.6%), High-Low (pre-ablation≥148.0 pg/mL, ΔBNP<-52.6%) and High-High (pre-ablation≥148.0 pg/mL, ΔBNP≥-52.6%). The primary endpoint was MACE, which included all-cause death, heart failure hospitalisation and other cardiovascular hospitalisations. The secondary endpoint involved arrhythmic recurrence.
resultsOf the 392 patients, 101 were classified as Low-Low, 91 as Low-High, 97 as High-Low and 103 as High-High. During a median follow-up of 5.3 (IQR: 3.2-7.2) years, 63 patients (16%) experienced MACE. Heart failure hospitalisation accounted for the majority of events (63%). The High-High subgroup showed significantly higher MACE rates than others (cumulative incidence (95% CI): 26.3% (16.2% to 35.2%), p<0.001). Low-High and High-High subgroups demonstrated a higher arrhythmic recurrence (p<0.001). After multivariate adjustment, the High-Low and High-High subgroups demonstrated progressively higher risks of MACE incidence compared with the Low-Low and Low-High subgroups. Both Low-High and High-High subgroups showed an elevated arrhythmic recurrence risk (both p<0.001).
conclusionsIntegrating pre-ablation and post-ablation BNP levels can be useful for identifying patients with persistent AF at high risk of MACE and arrhythmic recurrence during long-term follow-up.
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