Serum sRANKL/OPG predict recurrence after radiofrequency catheter ablation of lone atrial fibrillation.
BACKGROUND
Radiofrequency catheter ablation (RFCA) is a widely accepted strategy for eliminating atrial fibrillation (AF). A considerable recurrence rate has partly been ascribed to atrial remodeling. Osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/RANK ligand (RANKL) axis may contribute to the development and progression of AF by regulating atrial structural remodeling. This study aimed to determine the relationship between serum soluble RANKL (sRANKL)/OPG and the risk of recurrent arrhythmia after ablation of lone AF.


METHODS
We enrolled 527 lone AF patients undergoing first-time RFCA with complete follow-up data. Pre-ablation venous blood samples were obtained for measurement of serum sRANKL and OPG.


RESULTS
During the follow-up period of 15 (3-64)months, AF recurred in 187 patients (35.5%). Recurrence was associated with an elevation of serum sRANKL level and sRANKL/OPG ratio. In multivariate survival regression, persistent AF, AF duration, left atrial diameter, amiodarone after ablation, particularly serum sRANKL level and sRANKL/OPG ratio independently predicted AF recurrence. According to ROC curve analysis, the best diagnostic values of serum sRANKL level and sRANKL/OPG ratio for predicting recurrence were 4.89 pmol/l and 0.76, respectively.


CONCLUSIONS
Baseline serum high sRANKL level and sRANKL/OPG ratio are associated with AF recurrence after primary ablation procedure in lone AF patients, and may be used in the prediction of AF recurrence in these patients.
['Cao|Hailong|H|', 'Wu|Ying|Y|', 'Li|Qingguo|Q|', 'Wu|Yanhu|Y|', 'Zhou|Qing|Q|', 'Røe|Oluf Dimitri|OD|', 'Chen|Yijiang|Y|', 'Wang|Ruxing|R|', 'Wang|Dongjin|D|']
D000328:Adult D001281:Atrial Fibrillation D015415:Biomarkers D017115:Catheter Ablation D005260:Female D005500:Follow-Up Studies D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D057234:Preoperative Period D053245:RANK Ligand D012008:Recurrence D012307:Risk Factors D012995:Solubility D016896:Treatment Outcome
Recurrence Radiofrequency catheter ablation Lone atrial fibrillation Osteoprotegerin Soluble receptor activator of nuclear factor-κB ligand