Plasma N-terminal pro-Brain natriuretic peptide levels after hybrid therapy with pulmonary vein isolation and amiodarone for atrial fibrillation

DONG Xiao-li; TAN Ning; DENG Yu-jun

摘要：The purpose of this study was to investigate the effect of hybrid therapy and the relationship between the plasma N-terminal pro-Brain natriuretic peptide(NT-pro BNP)levels and the recurrence rate of the atrial fibrillation (AF)patients underwent pulmonary vein isolation(PVI)with or without amiodarone.Methods There were two groups in this study:control group and hybrid group.In the control group,54 patients(36 males,54±13 years)including paroxysmal(PAF)22,persistent(Pers-AF)15,and permanent AF(perm-AF)17,respectively,underwent the PVI procedure only;In the hybrid,63 AF patients(41 males,53±12 years)including PAF 24,Pers-AF 18,and perm-AF 21,respectively,underwent the PVI procedure and used amiodarone to enhance the effect of PVI.Blood samples were collected before and 3 months after PVI.NT-pro BNP concentrations were determined by immunoassays.Results In the control group,AF recurred in 29 patients(PAF 5 in 22,Pers-AF 11 in 15,and perm-AF 13 in 17)after the initial PVI procedure;And in the hybrid group,AF recurrred in 20 patiens(PAF 3 in 24,Pers-AF 7 in 18,and perm-Af 11 in 21).The average recurrent rate decreased significantly in the hybrid group(53.7% vs 31.7%,P＜0.01).While the NT pro-BNP level(pg/mL)was significantly different between the 2 groups(PAF 294.34±54.4 versus 241.69±17.6 pg/mL,P=0.047;Pers-AF 487.51±47.9 versus 248.76±19.4,P=0.001;Perm-AF 490.91±38.3 versus 300.86±31.8,P=0.032),While the NT pro-BNP level was also much lower in hybird group than control group in total(263.43±26.1 versus 409.88±49.7,P=0.02).Conclusions Sinus rhythm(SR)following AF ablation is associated with a dramatic decrease in NT-pro BNP.The hybrid group which had the administration of amiodarone after PVI would significantly decrease the plama NT pro-BNP levels and the recurrent rate of AF.