Urinary isoxanthopterin as a novel predictor following catheter ablation for atrial fibrillation

Abstract

Pulmonary vein isolation for atrial fibrillation (AF) has become widely accepted as a therapeutic strategy irrespective of the AF duration. However, the success rates of the first procedure are limited to around 50%-70% in paroxysmal and 40%-50% in persistent AF. 1 Of note, asymptomatic recurrence rate is approximately 50% following catheter ablation. 2,3 Patients with asymptomatic recurrence are at risk of cardiovascular events due to its delayed recognition and physicians' intervention. 4 Implantable loop recorders are recommended to monitor the recurrence of AF following catheter ablation. 5 However, given its invasiveness and high cost, it cannot be recommended for all Japanese candidates for catheter ablation. 6 Thus, methodologies to identify high-risk cohorts have been desired.Several biomarkers, including myocardial injury biomarkers, natriuretic peptides, and serum uric acid, as well as left atrial size, are

Letter by Kataoka, <i>et al</i>. Regarding Article, "Evaluation of Plasma Xanthine Oxidoreductase (XOR) Activity in Patients with Cardiopulmonary Arrest"

“…The authors focused on XOR alone, 1) but markers of oxidative stress such as urine isoxanthopterin may also be clinically useful. 3) Recently, uric acid has received much attention for assessing oxidative stress activity. Did the authors evaluate the relationship between plasma XOR activity and serum uric acid levels?…”

Clinical implication of hyperuricemia on the recurrence of atrial fibrillation after catheter ablation

“…Additionally, investigating the prognostic impact of xanthine oxidase, rather than uric acid, could yield more relevant insights. 4 The clinical implications of predicting recurrent AF using post-ablation data remain uncertain. Risk stratification of ablation candidates can be enhanced, allowing for more intensive ablation procedures, with reference to pre-procedural risk factors instead of post-procedural ones.…”

Detailed causality between high‐sensitivity C‐reactive protein and recurrence of atrial fibrillation after catheter ablation

“…An increase in hs‐CRP is reactive, and other original abnormalities should be found. For example, a variety of inflammatory‐related biomarkers have been proposed to be associated with AF recurrence, including urine isoxanthopterin, 2 interleukin‐6, natriuretic peptide, and uric acid. 3 Could the authors explain the reason why they focused on hs‐CRP rather than other biomarkers?…”