Article

Baseline NT-Pro-BNP levels and arrhythmia recurrence in outpatients undergoing elective cardioversion of persistent atrial fibrillation: a survival analysis.

Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
Indian pacing and electrophysiology journal 02/2009; 9(1):15-24. pp.15-24
Source: PubMed

ABSTRACT Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Elective electrical cardioversion is often performed in patients with persistent AF to attempt sinus rhythm (SR) restoration. However, AF recurrences are frequent after successful cardioversion and several predictors have been identified.
The present study was designed to prospectively analyse the correlation between NT-pro-BNP levels and AF recurrence in consecutive patients referred for electrical cardioversion of persistent atrial fibrillation.
Forty consecutive patients referred for elective cardioversion of AF were enrolled in the study. Cardioversion restored sinus rhythm in 34/40 patients but 2 of them presented an early recurrence of AF before discharge. Patients were then followed for 6 months to assess AF recurrence. Cox regression analysis was performed using the parameters found predictive on univariate survival analysis (NT-pro-BNP quartiles, beta-blockers). The only independent predictor of AF recurrence on Cox-regression analysis was a level of NT-pro-BNP in the fourth quartile (HR 3.21 95%CI 1.26-8.14, p=0.014). On receiver operating curve (ROC) analysis, NT-pro-BNP levels above 1707 pg/ml had a specificity of 92% (and a sensitivity of 36%) in predicting atrial fibrillation recurrence by 6 months.
Baseline NT-pro-BNP levels are an independent predictor of AF recurrence at 6 months follow-up in candidates for elective direct current cardioversion.

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Keywords

6 months follow-up
 
AF recurrence
 
AF recurrences
 
atrial fibrillation recurrence
 
attempt sinus rhythm
 
Baseline NT-pro-BNP levels
 
clinical practice
 
elective cardioversion
 
elective direct current cardioversion
 
Elective electrical cardioversion
 
electrical cardioversion
 
fourth quartile
 
independent predictor
 
NT-pro-BNP quartiles
 
persistent AF
 
persistent atrial fibrillation
 
prospectively analyse
 
sinus rhythm
 
successful cardioversion
 
univariate survival analysis