P309Plasminogen activator inhibitor-1 as a predictor of recurrence atrial fibrillation after radiofrequency catheter ablation of pulmonary veins

Roin Rekvava, S Berkonbaiev, N Tabagari-Bregvadze, Zurab Pagava

2018

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DOI 10.1093/europace/euy015.121
Data confidence 70 medium
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Abstract

Background: recurrence of atrial fibrillation (AF) after radiofrequency ablation (RFA) of pulmonary veins is the big problem for the patients and dear doctors . This study tests the hypothesis that Plasminogen activator inhibitor 1 (PAI 1) predict the development of postablation AF. Methods and Results: We enrolled 75 adult patients undergoing Radiofrequency Catheter Ablation of pulmonary vein for Atrial Fibrillation, all of them were in sinus rhythm after ablation within 3 months. After three months blood samples were obtained for measurement Plasminogen Activator Inhibitor I (PAI-1). Patients who developed recurrence AF after ablation (16 subjects, 21,3%) more likely to have a remote history of AF (P<0.001). Plasminogen activator inhibitor-1 (P=0.012) concentrations were significantly higher in the blood of patients who developed postablation AF than patient in SR after ablation. Logistic regression identified remote history of AF (P=0.001) and postablation PAI-1 (P=0.022) as independent predictors of postablation AF. The Chi-squared Automatic Interaction Detection (CHAID) model indicated that postablation PAI-1 antigen concentration determined risk of AF (12.5% if PAI-1≤28.5 ng/mL versus 45,3% if PAI-1>28.5 ng/mL). Conclusion: An elevated PAI-1 antigen concentration after radiofrequency ablation of pulmonary vein for atrial fibrillation is an independent predictor for development of postablation AF. More studies are needed to determine whether drugs that reduce PAI-1 concentrations can also reduce the risk of postablation atrial fibrillation.