Abstract

Background: The decision to discontinue anticoagulation therapy after catheter ablation for patients with atrial fibrillation (AF) is often problematic. High plasma B-Type natriuretic peptide (BNP) is associated with stroke events in general patients with AF.
Objective: This study sought to test the hypothesis that BNP predicts stroke events after catheter ablation of AF.
Methods: We investigated 1813 AF patients (1361 men, 63.2±10.4 years old, 60.3 % paroxysmal AF) who underwent an initial AF ablation with pre-ablation BNP measurement from AF Frontier Ablation Registry, a multicenter retrospective registry in Japan.
Results: The mean plasma BNP level before catheter ablation was 119.4±160.1 pg/mL. During a follow-up period (median 21.4 months), 20 patients (1.1%) suffered stroke after catheter ablation. The BNP levels of patients with stroke were significantly higher than those without stroke (278.6±322.8 vs 117.6±156.6 pg/mL, P<0.001). A multivariate analysis revealed that high BNP level, high age, and long-standing persistent AF were independent risk factors for stroke after catheter ablation. On receiver operating characteristic curve analysis for BNP levels to predict stroke, area under the curve was 0.717.
Conclusion: Elevation of BNP was independently related to the increased risk of stroke event after catheter ablation of AF. BNP might be useful in decision making regarding the discontinuation of anticoagulation after catheter ablation of AF.
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