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Serum markers of oxidative stress linked with AF

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The presence of derivatives of oxidative metabolites is associated with paroxysmal and persistent AF and is predictive of AF recurrence.

Researchers enrolled 306 patients with either paroxysmal (n=225) or persistent (n=81) AF who were scheduled for radiofrequency catheter ablation. The researchers measured derivatives of oxidative metabolites (DROM) as an index of oxidative stress, as well as P-wave signal-averaged electrocardiograms and high-sensitivity C-reactive protein levels. Patients were followed up for a mean of 1.2 years.

According to the study results, derivatives of oxidative metabolites were higher in patients with persistent AF vs. those with paroxysmal AF (341.6 ± 85.5 Carr units vs. 305.0 ± 77.7 Carr units, P<.001). Levels of DROM were also associated with filtered P-wave duration (P<.05), but not with left atrial dimension (P=.24). A tighter positive correlation between DROM levels and filtered P-wave duration was observed in patients with persistent AF (P<.001), but not in patients with paroxysmal AF (P=.42). High-sensitivity C-reactive protein also correlated with DROM levels in patients with AF (P<.001). Following catheter ablation, 221 patients remained free of AF and 85 patients had recurrent AF during follow-up. Patients in the highest quartile of DROM levels had a higher rate of AF recurrence than those in lower quartiles, and patients with paroxysmal AF had higher rates of recurrence (P<.01) vs. patients with persistent AF (P=.84).

“The results of this study show that DROM, a marker of serum oxidative stress, is closely linked to the presence of AF, which is accompanied by electrical atrial remodeling,” the researchers concluded. “The results also suggest that elevated basal DROM levels could be a risk factor for AF recurrence after radiofrequency ablation in paroxysmal AF patients, but whether elevated DROM levels is a cause or a consequence of recurrent AF is not certain. Thus, measurements of DROM could provide useful information in the management of AF.”

For more information:

• Shimano M. Heart Rhythm. 2009;6:935-940.