Changes in circulating biomarkers in symptomatic atrial fibrillation from before to one day after catheter ablation

Abstract

Abstract Atrial fibrillation (AF) causes debilitating symptoms in some patients, whereas others remain asymptomatic; the biological basis remains unclear. In this prospective case–control study, we investigated whether circulating biomarkers were associated with symptom burden, differed between patients with symptomatic AF and controls, and differed between samples collected before catheter ablation and on the first post-procedural day. We enrolled 100 patients undergoing first-time AF ablation and 100 age- and sex-matched controls; one patient with AF was excluded because of compromised blood samples. Symptoms were assessed using the AF6 questionnaire and EHRA score. Ninety-two proteins were measured using the Olink Target 96 Inflammation panel, and six additional biomarkers were analysed locally. The median AF6 was 23 (IQR 14–32), and 46% had modified EHRA score III. No statistically significant biomarker–symptom associations were detected after Bonferroni correction. In age- and sex-adjusted comparisons, 12 biomarkers differed between patients with AF and controls, including higher NT-proBNP, CCL20, and CXCL10, and lower FGF-19. On the first post-procedural day, 51 biomarkers differed significantly from pre-procedural levels, with the largest increases observed for hs-TnI, IL-6, and hs-CRP. These findings demonstrate biomarker differences between AF patients and controls and an acute post-procedural response consistent with myocardial injury and inflammation. Clinical trial registration: ClinicalTrials.gov NCT05201989 09/01/2022.

The authors' abstract, as published at the source. Scientific Reports, 2026 · DOI ↗