Which standard biomarkers are useful for the evaluation of myocardial injury after pulmonary vein isolation with cryoballoon?

Background: Many studies have used creatinine kinase (CK), myocardial bound for CK (CK-MB), and cardiac troponin I (cTnI) and T (cTnT) to evaluate myocardial cells injury after ablation. We applied measurements of the blood concentration of cardio-specific biomarkers as surrogates for the injured cell mass.

Aim: To clarify which of the standard biomarkers are useful in the evaluation and quantification of lesions produced by cryoballoon ablation (CBA) during pulmonary vein isolation.

Methods: The CBA was performed in 33 patients with atrial fibrillation. Blood samples were obtained before CBA and one, six, and 24 h after CBA. We analysed CK, CK-MB and cTnI.

Results: A significant increase of all biomarkers was observed at each hour of collection as compared to the baseline measurement. Maximum median peak levels occurred at 6 h. Pathological values of CK, CK-MB and cTnI were observed in 94%, 100% and 100% of patients, respectively. Both maximum CK and CK-MB values correlated with median temperature (p < 0.05) reached during CBA. Additionally, CK-MB correlated with total cryo-time (p < 0.03).

Conclusions: The CK-MB is the best biochemical marker for the evaluation of myocardial injury after CBA. The cTnI can be useful as an additional parameter of myocardial injury after CBA.