Background: We have reported previously that non-ischemic titrated cardiac injury by radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) mobilizes bone marrow derived CD34+ mononuclear cells. We hypothesized that the degree of post-RFCA CD34+ cell mobilization affects the clinical outcome of AF ablation. Methods and Results: Fifty-six patients (39 males, 53 ± 13 years) who underwent electrophysiology study (EPS; n = 10) or RFCA of AF (n = 46) were included. The peripheral blood CD34+ cell count and multiple serologic markers were evaluated before, immediately after the procedure. Results: 1. The percent increase of CD34+ cells (%ΔCD34+) was significant after RFCA as compared to EPS (p < 0.01). 2. The post-RFCA CD34+ cell count was significantly higher in patients who underwent RF energy delivery ≥ 80 min than those < 80 min (p = 0.024). 3. The %ΔCD34+ was linearly correlated with the plasma level of troponin I (R = 0.38, p < 0.01), but not with the non-ablation procedure time (p = NS). 3. During 30.2 ± 2.7 months follow-up, AF recurred in 37% of patients including early recurrence (34.8%). In contrast, the patients in whom AF recurred received a longer duration of RF energy delivery than those remaining in sinus rhythm (p = 0.04), they were associated with lower %ΔCD34+ (p = 0.02). Conclusion: CD34+ mononuclear cells were mobilized after catheter ablation by RF energy dose dependent manner, and the duration of RF energy delivery was longer in patients with AF recurrence. However, CD34+ mononuclear cell mobilization was significantly impaired in patients with recurring AF after RFCA.
Bibliographical noteFunding Information:
This work was supported by a grant ( A085136 ) from the Korea Health 21 R&D Project , the Ministry of Health and Welfare , and a grant ( 2010-0010537 ) from the Basic Science Research Program run by the National Research Foundation of Korea (NRF) , which is funded by the Ministry of Education, Science and Technology of the Republic of Korea. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology.
All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine