Korean Circ J.  2010 Apr;40(4):185-190. 10.4070/kcj.2010.40.4.185.

Serological Predictors for the Recurrence of Atrial Fibrillation After Electrical Cardioversion

• Kim SK
• Pak HN
• Park JH
• Ko KJ
• Lee JS
• Wi J
• Choi JI
• Kim YH

• KMID: 2145555
• DOI: http://doi.org/10.4070/kcj.2010.40.4.185

Abstract

BACKGROUND AND OBJECTIVES
Although electrical cardioversion (CV) is effective in restoring sinus rhythm (SR) 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. SUBJECTS AND METHODS: In 81 patients (M:F=63:18, 59.1+/-10.5 years old) with AF who underwent CV, clinical findings and pre-CV serologic markers were evaluated. RESULTS: During 13.1+/-10.6 months of follow-up, 8.6% (7/81) showed failed CV, 27.16% (22/81) showed early recurrence atrial fibrillation (ERAF; < or =2 weeks), 32.1% (26/81) had late recurrence atrial fibrillation (LRAF; >2 weeks), and 32.1% (26/81) remained in SR and had no recurrence (NR). Plasma levels of transforming growth factor beta (TGF)-beta were significantly higher in patients with failed CV than in those with successful CV (p=0.0260). Patients in whom AF recurred were older (60.4+/-9.0 years old vs. 55.3+/-12.5 years old, p=0.0220), and had lower plasma levels of stromal cell derived factor (SDF)-1alpha (p=0.0105). However, there were no significant differences in these parameters between ERAF patients and LRAF patients. CONCLUSION: Post-CV recurrence commonly occurs in patients aged >60 years and who have low plasma levels of SDF-1alpha. High plasma levels of TGF-beta predict failure of electrical CV.

Keyword

Atrial fibrillation; Electric countershock; Recurrence

MeSH Terms

Aged
Atrial Fibrillation
Chemokine CXCL12
Electric Countershock
Follow-Up Studies
Humans
Plasma
Recurrence
Stromal Cells
Transforming Growth Factor beta
Chemokine CXCL12
Transforming Growth Factor beta

Figure

• 

  Fig. 1 Kaplan-Meier curves suggest a higher recurrence rate of AF after successful CV in patients aged >60 years (A) and SDF-1α ≤3.0 ng/mL (B). AF: atrial fibrillation, CV: cardioversion.

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