Immunopathogenesis and Biomarkers of Recurrent Atrial Fibrillation Following Ablation Therapy in Patients with Preexisting Atrial Fibrillation

Overview

Journal Expert Rev Cardiovasc Ther

Specialty Cardiology & Vascular Diseases

Date 2018 Dec 25

PMID 30580643

Citations 6

Authors

John H Rosenberg

John H Werner

Gilman D Plitt

Victoria V Noble

Jordan T Spring

Brooke A Stephens

Aleem Siddique

Helenmari L Merritt-Genore

Michael J Moulton

Devendra K Agrawal

Affiliations

Soon will be listed here.

Abstract

Recurrent atrial fibrillation (RAF) following ablation therapy occurs in about 50% of patients. The pathogenesis of RAF is unknown, but is believed to be driven by atrial remodeling in the setting of background inflammation. Structural, electrophysiological and mechanical remodeling has been associated with atrial fibrillation (AF). Inflammation and fibrotic remodeling are the major factors perpetuating AF, as mediators released from the atrial tissues and cardiomyocytes due to mechanical and surgical injury could initiate the inflammatory process. In this article, we have critically reviewed the key mediators that may serve as potential biomarkers to predict RAF. Areas covered: Damage associated molecular patterns, heat shock proteins, inflammatory cytokines, non-inflammatory markers, markers of inflammatory cell activity, and markers of collagen deposition and metabolism are evaluated as potential biomarkers with molecular treatment options in RAF. Expert commentary: Establishing biomarkers to predict RAF could be useful in reducing morbidity and mortality. Investigations into the role of DAMPs participating in a sterile immune response may provide greater insight into the pathogenesis of RAF. Markers evaluating immune cell activity, collagen deposition, and levels of heat shock proteins show the greatest promise as potential biomarkers to predict RAF and develop novel therapies.

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