Clinical and serological predictors for the recurrence of atrial fibrillation after electrical cardioversion
Aims Although 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 results In 81 pati...
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| Veröffentlicht in: | Europace (London, England) England), 2009-12, Vol.11 (12), p.1632-1638 |
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| creator | Kim, Sook Kyoung Pak, Hui-Nam Park, Jae Hyung Ko, Kyoung Jeong Lee, Jihei Sara Choi, Jong Il Choi, Dong Hoon Kim, Young-Hoon |
| description | Aims
Although 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 results
In 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).
Conclusion
Post-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. |
| doi_str_mv | 10.1093/europace/eup321 |
| format | Article |
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Although 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 results
In 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).
Conclusion
Post-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.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/eup321</identifier><identifier>PMID: 19858160</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Atrial Fibrillation - diagnosis ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - prevention & control ; Biomarkers - blood ; Defibrillators, Implantable - utilization ; Female ; Humans ; Korea - epidemiology ; Male ; Middle Aged ; Outcome Assessment (Health Care) - methods ; Prevalence ; Prognosis ; Reproducibility of Results ; Risk Assessment - methods ; Risk Factors ; Secondary Prevention ; Sensitivity and Specificity ; Treatment Outcome</subject><ispartof>Europace (London, England), 2009-12, Vol.11 (12), p.1632-1638</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org. 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-d56d23481d42992c80d1595eb1161c9c41fdc6dbf882f2ddbb686c87efa185223</citedby><cites>FETCH-LOGICAL-c438t-d56d23481d42992c80d1595eb1161c9c41fdc6dbf882f2ddbb686c87efa185223</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1598,27901,27902</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/europace/eup321$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19858160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Sook Kyoung</creatorcontrib><creatorcontrib>Pak, Hui-Nam</creatorcontrib><creatorcontrib>Park, Jae Hyung</creatorcontrib><creatorcontrib>Ko, Kyoung Jeong</creatorcontrib><creatorcontrib>Lee, Jihei Sara</creatorcontrib><creatorcontrib>Choi, Jong Il</creatorcontrib><creatorcontrib>Choi, Dong Hoon</creatorcontrib><creatorcontrib>Kim, Young-Hoon</creatorcontrib><title>Clinical and serological predictors for the recurrence of atrial fibrillation after electrical cardioversion</title><title>Europace (London, England)</title><addtitle>Europace</addtitle><description>Aims
Although 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 results
In 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).
Conclusion
Post-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.</description><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - prevention & control</subject><subject>Biomarkers - blood</subject><subject>Defibrillators, Implantable - utilization</subject><subject>Female</subject><subject>Humans</subject><subject>Korea - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Outcome Assessment (Health Care) - methods</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Secondary Prevention</subject><subject>Sensitivity and Specificity</subject><subject>Treatment Outcome</subject><issn>1099-5129</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM1LxDAQxYMo7rp69ia5CULdJG26yVEWv2DBi55Lmkw00m3qpBX87-3aFY-e5g3vN4_hEXLO2TVnOl_CgLEzFkbR5YIfkDmXucgE0-Jw1EzrTHKhZ-QkpXfG2EpoeUxmXCupeMnmpFk3oQ3WNNS0jibA2MTXn71DcMH2ERP1EWn_BhTBDojQWqDRU9NjGDkfagxNY_oQW2p8D0ihATuauxRr0IX4CZhG-5QcedMkONvPBXm5u31eP2Sbp_vH9c0ms0Wu-szJ0om8UNwVQmthFXNcagk15yW32hbcO1u62islvHCurktVWrUCb7iSQuQLcjnldhg_Bkh9tQ3JwvhkC3FI1SrPmZJc78jlRFqMKSH4qsOwNfhVcVbtGq5-G66mhseLi332UG_B_fH7SkfgagLi0P2b9g3_UItV</recordid><startdate>20091201</startdate><enddate>20091201</enddate><creator>Kim, Sook Kyoung</creator><creator>Pak, Hui-Nam</creator><creator>Park, Jae Hyung</creator><creator>Ko, Kyoung Jeong</creator><creator>Lee, Jihei Sara</creator><creator>Choi, Jong Il</creator><creator>Choi, Dong Hoon</creator><creator>Kim, Young-Hoon</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20091201</creationdate><title>Clinical and serological predictors for the recurrence of atrial fibrillation after electrical cardioversion</title><author>Kim, Sook Kyoung ; Pak, Hui-Nam ; Park, Jae Hyung ; Ko, Kyoung Jeong ; Lee, Jihei Sara ; Choi, Jong Il ; Choi, Dong Hoon ; Kim, Young-Hoon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-d56d23481d42992c80d1595eb1161c9c41fdc6dbf882f2ddbb686c87efa185223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - prevention & control</topic><topic>Biomarkers - blood</topic><topic>Defibrillators, Implantable - utilization</topic><topic>Female</topic><topic>Humans</topic><topic>Korea - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Outcome Assessment (Health Care) - methods</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Secondary Prevention</topic><topic>Sensitivity and Specificity</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Sook Kyoung</creatorcontrib><creatorcontrib>Pak, Hui-Nam</creatorcontrib><creatorcontrib>Park, Jae Hyung</creatorcontrib><creatorcontrib>Ko, Kyoung Jeong</creatorcontrib><creatorcontrib>Lee, Jihei Sara</creatorcontrib><creatorcontrib>Choi, Jong Il</creatorcontrib><creatorcontrib>Choi, Dong Hoon</creatorcontrib><creatorcontrib>Kim, Young-Hoon</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Kim, Sook Kyoung</au><au>Pak, Hui-Nam</au><au>Park, Jae Hyung</au><au>Ko, Kyoung Jeong</au><au>Lee, Jihei Sara</au><au>Choi, Jong Il</au><au>Choi, Dong Hoon</au><au>Kim, Young-Hoon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical and serological predictors for the recurrence of atrial fibrillation after electrical cardioversion</atitle><jtitle>Europace (London, England)</jtitle><addtitle>Europace</addtitle><date>2009-12-01</date><risdate>2009</risdate><volume>11</volume><issue>12</issue><spage>1632</spage><epage>1638</epage><pages>1632-1638</pages><issn>1099-5129</issn><eissn>1532-2092</eissn><abstract>Aims
Although 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 results
In 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).
Conclusion
Post-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.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>19858160</pmid><doi>10.1093/europace/eup321</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Europace (London, England), 2009-12, Vol.11 (12), p.1632-1638 |
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| subjects | Atrial Fibrillation - diagnosis Atrial Fibrillation - epidemiology Atrial Fibrillation - prevention & control Biomarkers - blood Defibrillators, Implantable - utilization Female Humans Korea - epidemiology Male Middle Aged Outcome Assessment (Health Care) - methods Prevalence Prognosis Reproducibility of Results Risk Assessment - methods Risk Factors Secondary Prevention Sensitivity and Specificity Treatment Outcome |
| title | Clinical and serological predictors for the recurrence of atrial fibrillation after electrical cardioversion |
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