Cryoablation of Atrial Fibrillation in Cardiac Surgery: Outcomes and Myocardial Injury Biomarkers

Martínez‐Comendador, José Manuel; Castaño, Mario; Mosquera, Ignacio; Plana, Jesús Gómez; Gualis, Javier; Martín, Cristina; Mencía, Pilar

doi:10.1053/j.jvca.2011.06.011

Cited by 16 publications

(12 citation statements)

References 22 publications

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“…30 In our study, four out of five patients undergoing atrial fibrillation ablation belonged to the Cold Blood group in which, however, lower values of cTnI and CK-MB were found.…”

Section: Discussioncontrasting

confidence: 53%

Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia

et al. 2013

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Myocardial protection during cardiac surgery can be accomplished by different cardioplegic solutions. The aim of this study was to assess myocardial damage after heart valve surgery performed with myocardial protection of a single dose of Celsior cardioplegia or with repeated cold blood cardioplegia. After the stratification of 139 valvular patients by means of matching according to cross-clamp and cardiopulmonary bypass time, 32 patients were retained for comparison (16 patients received Celsior and 16 patients received cold blood cardioplegia). Creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) release were evaluated until six days after the operation. Pre-operative characteristics were similar in both groups. In the Celsior group, CK-MB and cTnI values were significantly higher from the first up to the sixth post-operative day. Peak cTnI values were 19.4 ± 13.4 and 9.7 ± 7 ng/mL (p=0.01) in the Celsior and the Cold Blood group, respectively. Peak CK-MB values were 79.6 ± 58.8 and 45.9 ± 20.6 U/L (p=0.07) in the Celsior and the Cold Blood group, respectively. Cold blood cardioplegia reduces perioperative myocardial damage compared to the Celsior solution in elective cardiac valve operations.

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“…30 In our study, four out of five patients undergoing atrial fibrillation ablation belonged to the Cold Blood group in which, however, lower values of cTnI and CK-MB were found.…”

Section: Discussioncontrasting

confidence: 53%

Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia

et al. 2013

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“…Different cardiac-specific biomarkers (e.g., CK-MB, troponin T, and troponin I) have been evaluated following surgical- or catheter-based ablation procedures. All of these markers are significantly increased after ablation 13,14 . However, none of these have significant prognostic value, most probably due to their lack of specificity for the atrial myocardium.…”

Section: Discussionmentioning

confidence: 93%

Myosin binding protein H-like (MYBPHL): a promising biomarker to predict atrial damage

Lahm

Dreßen

Beck

et al. 2019

Sci Rep

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Myosin binding protein H-like (MYBPHL) is a protein associated with myofilament structures in atrial tissue. The protein exists in two isoforms that share an identical amino acid sequence except for a deletion of 23 amino acids in isoform 2. In this study, MYBPHL was found to be expressed preferentially in atrial tissue. The expression of isoform 2 was almost exclusively restricted to the atria and barely detectable in the ventricle, arteria mammaria interna , and skeletal muscle. After atrial damage induced by cryo- or radiofrequency ablation, MYBPHL was rapidly and specifically released into the peripheral circulation in a time-dependent manner. The plasma MYBPHL concentration remained substantially elevated up to 24 hours after the arrival of patients at the intensive care unit. In addition, the recorded MYBPHL values were strongly correlated with those of the established biomarker CK-MB. In contrast, an increase in MYBPHL levels was not evident in patients undergoing aortic valve replacement or transcatheter aortic valve implantation. In these patients, the values remained virtually constant and never exceeded the concentration in the plasma of healthy controls. Our findings suggest that MYBPHL can be used as a precise and reliable biomarker to specifically predict atrial myocardial damage.

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“…Furthermore, the occurrence of new left bundle-branch block or pathologic Q-waves, evidence of native coronary artery or new graft occlusion, loss of viable myocardium by imaging, or prolonged chest pain was required. 15 Postoperative acute kidney failure was defined as a creatinine level of 2.0 mg/dL or greater and a greater than 50% increase in the previous preoperative value. A respiratory complication was defined as prolonged ventilation, reintubation, or tracheostomy, or a diagnosis of culture-positive pneumonia.…”

Section: Postoperative Outcomesmentioning

confidence: 99%

Subclinical Hypothyroidism Might Increase the Risk of Postoperative Atrial Fibrillation after Aortic Valve Replacement

Martínez‐Comendador

Vidal

Gualis

et al. 2015

Thorac cardiovasc Surg

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Background To evaluate the influence of subclinical hypothyroidism (SCH) on the development of postoperative atrial fibrillation (AF) in patients undergoing aortic valve replacement surgery with extracorporeal circulation. Methods A prospective study in a tertiary hospital between July 2005 and December 2013 in which all patients undergoing aortic valve replacement with no other valve surgery were consecutively included. Patients who were in preoperative sinus rhythm were selected and they underwent thyroxine (T4) and thyroid-stimulating hormone determination in the month before surgery. Postoperative AF was defined as the development of AF during hospital admittance. Descriptive analysis and binary logistic regression were performed for the target variable. Results A total of 467 patients were studied, with 35 cases of SCH. The incidence of postoperative AF was 57% in the group with SCH versus 30.3% (p = 0.001) in the group without hypothyroidism, without significant differences in other postoperative complications. In the logistic regression analysis, the independent predictors of postoperative AF were SCH, age, and aortic clamping time. SCH multiplies the odds ratio of postoperative AF by 3.14 (95% confidence interval: 1.24-7.96). Conclusion SCH behaves like a risk factor for the development of postoperative AF in patients undergoing aortic valve replacement with extracorporeal circulation. Other studies are needed to determine whether preoperative T4 replacement therapy and/or more aggressive AF prophylaxis can prevent this complication in patients undergoing aortic valve replacement.

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Cryoablation of Atrial Fibrillation in Cardiac Surgery: Outcomes and Myocardial Injury Biomarkers

Cited by 16 publications

References 22 publications

Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia

Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia

Myosin binding protein H-like (MYBPHL): a promising biomarker to predict atrial damage

Subclinical Hypothyroidism Might Increase the Risk of Postoperative Atrial Fibrillation after Aortic Valve Replacement

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