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Objectives: The purpose of this study was to determine the relationship between matrix metalloproteinase 9 and atrial fibrillation recurrence after catheter ablation.
Background: Matrix metalloproteinase – 9 (MMP-9) is involved in extracellular matrix remodeling which is a marker of extracellular collagen degradation.
Methods: An enzyme-linked immunosorbent assay prior to a radiofrequency catheter ablation (RFA) procedure was used for measuring the serum level of MMP-9 in 210 patients: 80 patients without history of atrial fibrillation (AF) and 80 patients with idiopathic AF (paroxysmal AF – 30, persistent AF – 32, long-standing AF – 35 and permanent AF – 33). Their relationship with intraoperative efficacy and recurrence of AF was evaluated throughout the entire observation period.
Results: The observation period was 22.2 ± 7.9 months. MMP-9 level was higher in the groups of patients with AF than in the control group: 170.5 ± 24.2, 202.7±28.4, 230.8 ± 21.1 and 252.6 ± 24.5 ng/ml for paroxysmal, persistent, long-standing and permanent forms of AF. In the control group, MMP-9 level was 75.9 ± 14.6 ng/ml. MMP-9 level increased with the progression of AF (p <0.05). A multifactor analysis showed that MMP-9 level, history of atrial fibrillation and left atrial volume were independent predictors of sinus rhythm recovery and recurrence of AF.
Conclusion: An increase in MMP-9 level in patients with AF has been shown. An increase in MMP-9 levels was observed as AF progressed. MMP-9 is an independent predictor of arrhythmia recurrence after RFA.