ABSTRACT

Aim:

Catheter ablation of atrial fibrillation (AF) is a favourable therapeutic option for the treatment of patients, who are symptomatic despite antiarrhythmic medication. However, this procedure may lead to thromboembolic complications, especially stroke. We aimed to measure serum neuron-specific enolase (NSE) levels, which is known as biomarker of acute neuronal injury, during and after the ablation.

Materials and Methods:

Forty three patients with paroxysmal AF underwent pulmonary vein isolation performed by radiofrequency ablation. A neurological examination was performed pre- and postprocedural period. Serum NSE levels were determined before and at the end of the procedure, at 2, 24 and 48 hours after the procedure.

Results:

None of the patients developed new neurological deficits. But NSE levels increased after ablation above the upper reference limit of 17 ng/ml in 14 patients; and also 50% increase was observed compared to baseline in 33 patients. No clinical parameters such as age, hypertension, previous history of stroke, diabetes mellitus, atherosclerotic heart disease, CHA2DS2 VASc score (composite risk score (1 point each): comprising congestive heart failure, hypertension, age ≥ 75 years (2 points), diabetes, stroke (2 points), age ≥ 65 years, vascular disease and female gender) and no procedural parameters such as activated clotting time value, total procedure time, electrical cardioversion were associated with an increased level of NSE. But, patients with increased NSE level above the upper reference limit had larger left atrium and patients with 50% increase in NSE level had lower systolic blood pressure during the procedure.

Conclusion:

Serum NSE level increased in most of the patients undergoing catheter ablation for AF, also in one third of the patients it exceeded the upper reference limit. Despite increase in NSE is a marker of neuronal injury, clinical importance of this finding should be evaluated in a longitudinal study”