Related Experiment Video
Updated: Aug 15, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
High sensitivity C-reactive protein: a novel predictor for recurrence of atrial fibrillation after successful
Joseph F Malouf1, Ravi Kanagala, Faisal O Al Atawi
1Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Insights
High C-reactive protein (CRP) levels predict atrial fibrillation (AF) recurrence after cardioversion. This finding suggests anti-inflammatory treatments may help maintain normal sinus rhythm and identify patients benefiting most from cardioversion therapy.
Area of Science:
- Cardiology
- Inflammation Biomarkers
Background:
- C-reactive protein (CRP) levels are known to predict immediate failure of cardioversion (CV) in atrial fibrillation (AF) patients.
- Inflammation plays a role in the pathophysiology of AF.
Purpose of the Study:
- To investigate if C-reactive protein (CRP) levels can predict the recurrence of atrial fibrillation (AF) after successful electrical cardioversion (CV).
Main Methods:
- Prospective measurement of high-sensitivity CRP in 67 patients with AF or atrial flutter undergoing successful electrical CV.
- One-month follow-up to assess arrhythmia recurrence.
Main Results:
- 33% of patients experienced arrhythmia recurrence within one month.
- Higher pre-CV CRP levels were significantly associated with recurrence (OR 1.84, p=0.013).
- CRP remained the sole independent predictor of recurrence after multivariate analysis (OR 2.19, p=0.036).
Conclusions:
- Elevated CRP levels indicate an increased risk of short-term AF recurrence post-CV.
- Findings support exploring anti-inflammatory strategies to maintain sinus rhythm after CV.
- CRP may aid in identifying patients likely to benefit most from CV therapy.
Objectives:
We sought to test the hypothesis that C-reactive protein (CRP) can predict the recurrence of atrial fibrillation (AF) after successful electrical cardioversion (CV).
Background:
In patients with AF, CRP levels are predictive of immediate failure of CV.
Methods:
We prospectively measured high-sensitivity CRP in 67 patients with AF or atrial flutter who underwent successful electrical CV.
Results:
At one-month follow-up, 22 patients (33%) had recurrence of their arrhythmia. Arrhythmia recurrence was associated with significantly higher pre-CV CRP levels (odds ratio [OR] 1.84; 95% confidence interval [CI] 1.14 to 2.98; p = 0.013) even after adjusting for age (OR 2.22; 95% CI 1.25 to 3.93; p = 0.006), for gender (OR 1.89; 95% CI 1.16 to 3.09; p = 0.011), or duration of arrhythmia (OR 1.86; 95% CI 1.13 to 3.07; p = 0.015). On multivariate analysis, CRP was the only independent predictor of arrhythmia recurrence (OR 2.19; 95% CI 1.05 to 4.55; p = 0.036).
Conclusions:
Our data suggest that high levels of CRP are associated with an increased risk of recurrence of AF within one month. These data support the hypothesis that anti-inflammatory interventions may help in maintenance of normal sinus rhythm after CV. These data also may have implications for the identification of patients who are most likely to experience substantial benefit from CV therapy for AF.
Related Concept Videos
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...