Activation of generalised inflammatory reaction following electrical cardioversion
Jacek Gajek1, Dorota Zyśko, Andrzej Mysiak
1Department of Cardiology, Medical University of Wroclaw, Poland.
Insights
External direct current cardioversion (DC) for atrial fibrillation (AF) significantly increases C-reactive protein (CRP) levels, indicating an inflammatory response. This finding highlights the body's reaction to the procedure.
Area of Science:
- Cardiology
- Electrophysiology
- Inflammation Markers
Background:
- Atrial fibrillation (AF) restoration carries thrombo-embolic risks due to impaired atrial function.
- Direct current cardioversion (DC) for AF may induce myocardial injury and inflammation.
- C-reactive protein (CRP) serves as a key non-specific marker for inflammation.
Purpose of the Study:
- To investigate the impact of external DC on atrial fibrillation (AF) and atrial flutter (AFlut) on inflammatory processes.
- To assess changes in CRP plasma concentration following DC.
Main Methods:
- 35 patients with AF/AFlut underwent elective DC.
- CRP plasma levels were measured pre-DC and 24 hours post-DC.
- Statistical analysis explored correlations between CRP, patient characteristics, and DC parameters.
Main Results:
- CRP levels significantly increased post-DC (3.9 to 7.2 ng/ml, p<0.0001).
- Pre- and post-DC CRP levels showed a strong positive correlation (r=0.72, p<0.0001).
- CRP elevation correlated with BMI but not with gender, DC energy, or number of shocks.
Conclusions:
- External DC for AF/Aflut demonstrably activates inflammatory processes.
- A significant rise in CRP plasma concentration confirms this inflammatory response.
- The study quantifies the inflammatory effect of DC in AF/AFlut patients.
Background:
Restoration of sinus rhythm in patients with atrial fibrillation (AF) is associated with an increased risk of thrombo-embolic complications due to delayed return of the left atrial and left atrial appendage systolic function. Direct current cardioversion (DC), used for AF termination, may cause myocardial injury and subsequent activation of inflammatory response. A C-reactive protein (CRP) is a non-specific marker of inflammation.
Aim:
To examine the effects of external DC of AF or atrial flutter (AFlut) on inflammatory processes.
Methods:
The study group consisted of 35 patients (20 females and 15 males, mean age 67.9+/-9.7 years, range 46-83 years) with paroxysmal or persistent AF/AFlut who underwent elective DC. CRP plasma concentration was measured before and 24 hours after DC.
Results:
The mean total DC energy was 431.2 J. CRP plasma concentration increased significantly following DC - from 3.9+/-3.4 ng/ml before DC to 7.2+/-6.7 ng/ml after DC (p<0.0001). CRP level correlated with body mass index (r=0.34, p<0.05), however, this correlation became non-significant after inclusion of the presence of diabetes into the statistical model. There was also a positive correlation between CRP values before and after DC (r=0.72, p<0.0001). No correlation between CRP and gender, total power of DC nor the number of DC shocks was detected.
Conclusions:
External DC of AF/Aflut causes activation of inflammatory processes measured as a significant increase in the CRP plasma concentration.
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