Relationship between oxidative stress markers and clinical outcomes of radiofrequency ablation in patients with atrial fibrillation

Introduction. Oxidative stress holds a prominent position among the complex and multifactorial pathological mechanisms of atrial fibrillation (AF). It induces structural changes in the atria, promotes myocardial remodeling and arrhythmia progression, and is associated with recurrences after interventional treatment. Currently, there is a lack of data regarding the relationship between plasma levels of oxidative stress biomarkers and the clinical efficacy of catheter ablation for AF in patients with cardiac arrhythmias.

Aim: To assess levels of laboratory biomarkers of prooxidant and antioxidant status in the blood plasma of patients with AF and their relationship with the effectiveness of interventional treatment.

Material and Methods. The study included 39 patients with idiopathic AF hospitalized for interventional treatment by radiofrequency ablation (RFA) of the pulmonary vein ostia. Quantitative determination of biomarkers in the blood was performed by enzyme-linked immunosorbent assay (ELISA) before the surgery. Data on AF relapses and the time of their onset were collected and analyzed for 3 months.

Results. The patients were divided into groups: 1st gr. – paroxysmal AF, 2d gr. persistent, 3d gr. long-term persistent. In all groups, the PerOx level corresponded to a high degree of oxidative stress. In 1st gr. and 3d gr., the relationships between PerOx and the CRP level are shown. An increase in the duration of the disease period was associated with a decrease in the concentration of Gpx1 in the 1st gr. For 2d gr., the relationship of PerOx with the age of patients is shown. The effectiveness of RFA did not differ significantly between the groups and amounted to 78,6, 75 and 84,6%, respectively. The relationships of biomarkers with the development of arrhythmia recurrence after RFA are shown. In 1st gr., in patients with episodes of arrhythmia, the PerOx level was higher compared to other forms of AF.

Conclusion. Measuring biomarkers reflecting systemic oxidative stress and antioxidant status in patients with AF is a promising tool for monitoring and evaluating the effectiveness of interventional arrhythmia treatment.

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