The Impact of Transforming Growth Factor-β1 Level on Outcome After Catheter Ablation in Patients With Atrial Fibrillation.

INTRODUCTION: Transforming growth factor-β1 (TGF-β1 ) is an important factor that induces atrial fibrosis and atrial fibrillation (AF). The purpose of this study was to evaluate the association between TGF-β1 level and clinical factors before catheter ablation (CA), and to investigate the impact of TGF-β1 level on the outcome after CA for AF.

METHODS AND RESULTS: This prospective study included 151 patients (persistent AF group: n = 59, paroxysmal AF [PAF] group: n = 54, and control group: n = 38). All patients who underwent CA for AF were followed up for 12 months. The PAF group had the highest TGF-β1 levels in all patients. An early recurrence of AF (ERAF: defined as episodes of atrial tachyarrhythmia within a 3-month blanking period) was detected in 60 patients (53%). Recurrent AF after the blanking period was detected in 36 patients (32%). On multivariate analysis, low TGF-β1 level was the only independent factor associated with recurrent AF. Moreover, the AF recurrence ratio was higher in the low TGF-β1 group (< 12.56 ng/mL) than in the high TGF-β1 group (16 of 29 patients, 55% vs. 20 of 84 patients, 24%, P = 0.002 by log-rank test).

CONCLUSIONS: PAF was associated with a higher TGF-β1 level. Moreover, lower TGF-β1 level in AF patients could be a cause of recurrent AF after CA.