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.