Utility of ST2 soluble biomarker in patients with atrial fibrillation and pulmonary veins isolation

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: Public hospital(s). Main funding source(s): No fundings related BACKGROUND: Atrial fibrillation (AF) is the more frequent arrhythmia in clinical practice and the efficacy of pulmonary vein ablation has being widely demonstrated. There is still a lack of information about the predictive value of electroanatomical voltage maps or biomarkers to predict recurrence. PURPOSE: ST2 soluble (ST2S) biomarker has being previously analyzed by our group in patients with AF and electrical cardioversion demonstrating utility to predict recurrence . So we sought to analyze the clinical utility of ST2S biomarker in patients with AF that underwent to an electrophysiology study and pulmonary isolation (PVI) to compare the predictive value of this biomarker. RESULTS: This was a prospective, observational clinical trial that included a total of 156 patients with AF who were referred to our hospital for a PVI from September 2016 to September 2019. We also included 40 matched control patients for the initial analysis. All the patients with AF underwent an electroanatomical voltage map in sinus rhythm and PVI. From the 156 PVI: 68 had paroxysmal AF and 88 persistent. ST2S mean value in AF patients was of (13178.5 pg/ml) and had no significant difference with matched controls (11016.2 pg/ml) in baseline analysis. There was no association of ST2S baseline values and recurrence in AF patients. When we analyzed by type of AF, persistent AF patients had a significantly higher level of the biomarker and there was also a significant elevation of the biomarker according to heart rate (>100 bpm) (p 0.038). We observed an elevation of the ST2S levels at 3 and 6 months follow-up with no difference according to recurrence. The levels of ST2S were lower in the cases with a lower voltage map area and in the cases with a wider lower map area but there was no a significant association nor with recurrence. In multivariant analysis only AF rhythm and LA index volume was a significant predictor or recurrence at 3 months follow-up. CONCLUSIONS: We consider that even though there is an association with AF patients and ST2S biomarker levels, specially in those with persistent AF, in patients undergoing an PVI, ST2S values had a generalized elevation at follow-up probably related to inflammation and were not predictive of recurrence. [Figure: see text] [Figure: see text]