Elevated Levels of Brain Natriuretic Peptide in Patients Cured of Paroxysmal Atrial Fibrillation after Pulmonary Vein Isolation

Background: Little is known about long-term courses of brain natriuretic peptide (BNP) levels in patients with paroxysmal atrial fibrillation (PAF) who have a normal sinus rhythm after successful pulmonary vein isolation (PVI). Objective: The aim of this study was to investigate the changes in the BNP levels of patients who had successfully undergone PVI. Methods and Results: The study population included 56 consecutive patients (age, 63±12 years; men, 39) who had undergone PVI with no recurrence of arrhythmia in the follow-up periods of 1.9 years. Elevated BNP levels (i.e. ≥18.4 pg/mL) were observed in 39 (70%) patients at the baseline. Overall, the BNP levels had significantly decreased after successful ablation (from 62.9±81.4 pg/mL to 34.7±36.3 pg/mL, P<0.001). However, the BNP levels were reduced to within the normal range only in 10 out of the 39 (26%) patients with elevated BNP levels at the baseline. Conclusion: The BNP levels had decreased in patients cured of PAF after successful PVI. In spite of elimination of arrhythmia, most of the patients show a mild elevation in their BNP levels, which remained far below the cut-off value for heart failure (100 pg/mL).