Plasma Brain Natriuretic Peptide Level After Hybrid Therapy With Pulmonary Vein Isolation and Antiarrhythmic Drugs for Atrial Fibrillation

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概要

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• The atrial fibrillation (AF) recurrence rate after pulmonary vein isolation (PVI) has been relatively high and in some unsuccessful PVI cases, antiarrhythmic drugs that were ineffective before PVI may become effective (hybrid therapy). The purpose of this study was to investigate the relationship between the brain natriuretic peptide (BNP) level and the effect of the hybrid therapy. In 28 lone AF patients undergoing hybrid therapy, the plasma BNP level was measured before PVI and before and 3 months after administering an antiarrhythmic drug. Fifteen patients were free of AF after the hybrid therapy (effective group), and 13 still had recurrent AF after (noneffective group). At baseline, in all patients the BNP level was elevated, and there were no significant differences in the BNP level between the 2 groups. The BNP level was significantly decreased after PVI in the effective group (56.8 ± 23.1 versus 37.5 ± 16.7 pg/mL, P < 0.05) but not in the noneffective group (74.3 ± 47.8 versus 79.7 ± 54.4 pg/mL, NS). The elevated BNP level normalized in all effective group patients. The criterion consisting of a net value of < 60.0 pg/mL or a reduction in the BNP level of > 10.0 pg/mL after PVI predicted the effective group patients with a high accuracy. A significant reduction in the BNP level after PVI may be a useful predictor of the responders to antiarrhythmic drug therapy in patients with recurrent AF after PVI. The hybrid therapy may be effective in patients whose PVs serve as a dominant AF substrate.

著者

• Yamada Takumi

  Division Of Cardiovascular Disease University Of Alabama At Birmingham

• Okada Taro

  Division Of Cardiology Aichi Prefecture Cardiovascular And Respiratory Center

• Tsuboi Naoya

  Division Of Cardiology Chukyo Hospital And Nagoya University School Of Health Sciences

• Hirai Makoto

  Department Of Circulation And Respiration Research Institute Of Environmental Medicine Nagoya Univer

• Yoshida Yukihiko

  Division Of Cardiology Nagoya Dai-ni Red Cross Hospital Cardiovascular Center

• Yoshida Naoki

  Division of Cardiology, Aichi Prefectural Cardiovascular and Respiratory Center

• Inden Yasuya

  Department Of Cardiology Nagoya University Graduate School Of Medicine

• Murakami Yoshimasa

  Division Of Cardiology Aichi Prefecture Cardiovascular And Respiratory Center

• Toyama Junji

  Division Of Cardiology Aichi Prefectural Cardiovascular And Respiratory Center

• Murohara Toyoaki

  Department Of Cardiology Nagoya Graduate School Of Medicine

• Yoshida Naoki

  Division Of Cardiology Aichi Prefectural Cardiovascular And Respiratory Center

• Tsuboi Naoya

  Division of Cardiology, Nagoya Dai-ni Red Cross Hospital, Cardiovascular Center

• Okada Taro

  Division of Cardiology, Aichi Prefectural Cardiovascular and Respiratory Center

• Yoshida Yukihiko

  Division of Cardiology, Nagoya Dai-ni Red Cross Hospital, Cardiovascular Center

• Hirai Makoto

  Department of Cardiology, Nagoya University Graduate School of Health Science

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