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

Background 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.