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Open AccessArticle

Modulation of SERCA in Patients with Persistent Atrial Fibrillation Treated by Epicardial Thoracoscopic Ablation: The CAMAF Study

1
Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
2
Department of Medical Sciences, International University of Health and Medical Sciences “Saint Camillus”, 00131Rome, Italy
3
Department of Advanced Biomedical Sciences, International Translational Research and Medical Education Academic Research Unit (ITME), “Federico II” University, 80138 Naples, Italy
4
Department of Medicine, Albert Einstein College of Medicine, Fleischer Institute for Diabetes and Metabolism (FIDAM), Montefiore University Hospital, New York, NY 10461, USA
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Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, 86010, Campobasso, Italy
6
Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
7
Cardiovascular and Arrhythmias Department, Catholic University of Sacred Heart, 86010 Campobasso, Italy
8
Cardiovascular and Arrhythmias Department, “Vecchio Pellegrini” Hospital; 80138 Naples, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(2), 544; https://doi.org/10.3390/jcm9020544
Received: 20 January 2020 / Revised: 13 February 2020 / Accepted: 14 February 2020 / Published: 17 February 2020
Objectives: To evaluate atrial fibrillation (AF) recurrence and Sarcoplasmic Endoplasmic Reticulum Calcium ATPase (SERCA) levels in patients treated by epicardial thoracoscopic ablation for persistent AF. Background: Reduced levels of SERCA have been reported in the peripheral blood cells of patients with AF. We hypothesize that SERCA levels can predict the response to epicardial ablation. Methods: We designed a prospective, multicenter, observational study to recruit, from October 2014 to June 2016, patients with persistent AF receiving an epicardial thoracoscopic pulmonary vein isolation. Results: We enrolled 27 patients. Responders (n = 15) did not present AF recurrence after epicardial ablation at one-year follow-up; these patients displayed a marked remodeling of the left atrium, with a significant reduction of inflammatory cytokines, B type natriuretic peptide (BNP), and increased levels of SERCA compared to baseline and to nonresponders (p < 0.05). Furthermore, mean AF duration (Heart rate (HR) 1.235 (1.037–1.471), p < 0.05), Left atrium volume (LAV) (HR 1.755 (1.126–2.738), p < 0.05), BNP (HR 1.945 (1.895–1.999), p < 0.05), and SERCA (HR 1.763 (1.167–2.663), p < 0.05) were predictive of AF recurrence. Conclusions: Our data indicate for the first time that baseline values of SERCA in patients with persistent AF might be predictive of failure to epicardial ablative approach. Intriguingly, epicardial ablation was associated with increased levels of SERCA in responders. Therefore, SERCA might be an innovative therapeutic target to improve the response to epicardial ablative treatments. View Full-Text
Keywords: persistent atrial fibrillation; epicardial ablation; calcium channels; SERCA persistent atrial fibrillation; epicardial ablation; calcium channels; SERCA
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Sardu, C.; Santulli, G.; Guerra, G.; Trotta, M.C.; Santamaria, M.; Sacra, C.; Testa, N.; Ducceschi, V.; Gatta, G.; D' Amico, M.; Sasso, F.C.; Paolisso, G.; Marfella, R. Modulation of SERCA in Patients with Persistent Atrial Fibrillation Treated by Epicardial Thoracoscopic Ablation: The CAMAF Study. J. Clin. Med. 2020, 9, 544.

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