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Published on: February 26, 2013

C reactive protein concentration and recurrence of atrial fibrillation after electrical cardioversion

O Wazni1, D O Martin, N F Marrouche

  • 1The Center for Atrial Fibrillation, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.

Heart (British Cardiac Society)
|May 14, 2005
PubMed

Insights

High C-reactive protein (CRP) levels predict atrial fibrillation (AF) recurrence after cardioversion in patients on antiarrhythmic drugs. This suggests inflammation plays a role in drug-resistant AF.

Area of Science:

  • Cardiology
  • Inflammation research
  • Medical diagnostics

Background:

  • Atrial fibrillation (AF) recurrence post-cardioversion is a clinical challenge.
  • Antiarrhythmic drugs are commonly used but do not always prevent AF recurrence.
  • The role of inflammation, indicated by C-reactive protein (CRP), in AF recurrence is under investigation.

Purpose of the Study:

  • To determine if elevated C-reactive protein (CRP) levels predict atrial fibrillation (AF) recurrence after cardioversion.
  • To investigate the association between CRP concentration and AF recurrence in patients receiving antiarrhythmic drugs.

Main Methods:

  • 111 patients undergoing direct current cardioversion for symptomatic AF were enrolled.
  • Blood samples for C-reactive protein (CRP) were collected on the day of cardioversion.
  • All participants were on antiarrhythmic drugs before and after the procedure, with follow-up for AF recurrence.

Main Results:

  • Atrial fibrillation (AF) recurred in 75 out of 111 patients after a mean follow-up of 76 days.
  • Median CRP levels were significantly higher in patients with AF recurrence (3.95 mg/l vs. 1.81 mg/l, p = 0.002).
  • Patients in the upper CRP percentile had a 2.0-fold increased risk of AF recurrence (p = 0.007), indicating a strong association.

Conclusions:

  • C-reactive protein (CRP) is an independent predictor of atrial fibrillation (AF) recurrence post-electrical cardioversion in patients on antiarrhythmic therapy.
  • These findings suggest that inflammation may contribute to the development of AF that is resistant to antiarrhythmic drugs.
  • CRP measurement could aid in risk stratification for AF recurrence.
Abstract

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