Clinical and serological predictors for the recurrence of atrial fibrillation after electrical cardioversion

Sook Kyoung Kim, Hui Nam Pak, Jae Hyung Park, Kyoung Jeong Ko, Jihei Sara Lee, Jong Il Choi, Dong Hoon Choi, Young Hoon Kim

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30 Citations (Scopus)

Abstract

AimsAlthough electrical cardioversion (CV) is effective in restoring sinus rhythm in patients with atrial fibrillation (AF), AF frequently recurs in spite of antiarrhythmic medications. We investigated the predictors of failed CV and AF recurrence after successful CV.Methods and resultsIn 81 patients (M:F = 63:18, 59.1 ± 10.5 years old) with AF who underwent CV, clinical, image, and CV findings (energy requirement, immediate recurrence of AF < 15 min), and pre-CV serological markers were evaluated. Results: (i) During 13.1 ± 10.6 months of follow-up, 8.6 (7/81) showed failed CV, 59.26 (48/81) showed AF recurrence, and 32.1 (26/81) remained in sinus rhythm (no recurrence). (ii) Failed CV showed higher plasma levels of transforming growth factor (TGF)- (P = 0.0260) than those with successful CV. (iii) Patients with AF recurrence were older (60.4 ± 9.0 years old vs. 55.3 ± 12.5years old, P = 0.0220), had a higher incidence of spontaneous echo contrast (SEC; 68.1 vs. 40.0, P = 0.0106), a lower prescription rate of angiotensin-converting enzyme inhibitor (ACE-I)/angiotensin receptor blocker (ARB; 27.0 vs. 50.0, P = 0.0248) or spironolactone (0.0 vs. 19.2, P = 0.0007), and lower plasma levels of stromal cell-derived factor (SDF)-1 (P = 0.0105).ConclusionPost-CV recurrence commonly occurs in patients with age >60 years, SEC, under-utilization of ACE-I/ARB or spironolactone, and low plasma levels of SDF-1. High plasma level of TGF- predicts failed CV.

Original languageEnglish
Pages (from-to)1632-1638
Number of pages7
JournalEuropace
Volume11
Issue number12
DOIs
Publication statusPublished - 2009 Dec 1

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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