title: Brain natriuretic peptide predicts successful cardioversion in patients with atrial fibrillation and maintenance of sinus rhythm.
abstract: BACKGROUND
  Brain natriuretic peptide (BNP) is released from the heart by hemodynamically induced muscle stretch. Patients with atrial fibrillation have higher levels of BNP than those in sinus rhythm.
  
  
  OBJECTIVE
  To assess the usefulness of BNP as a predictor of successful cardioversion in patients with persistent atrial fibrillation and subsequent maintenance of sinus rhythm.
  
  
  METHODS
  Twenty patients undergoing cardioversion for persistent atrial fibrillation were enrolled. BNP levels were measured before electric cardioversion, and 30 min and two weeks after cardioversion. Baseline echocardiograms and 12-lead electrocardiograms were obtained from all patients. Patients with valvular disease, previous mitral valve surgery or significant left ventricular dysfunction were excluded.
  
  
  RESULTS
  The mean BNP level and the mean heart rate were significantly higher before cardioversion than 30 min after (197+/-132 pg/mL versus 164+/-143 pg/mL, P=0.02, and 77+/-17 beats/min versus 57+/-12 beats/min, P=0.0007, respectively). Patients who reverted back to atrial fibrillation after two weeks had a baseline BNP of 293+/-106 pg/mL, while those who remained in sinus rhythm for two weeks had a lower baseline BNP of 163+/-122 pg/mL (P=0.02).
  
  
  CONCLUSIONS
  In patients with persistent atrial fibrillation, BNP levels are associated with successful cardioversion and maintenance of sinus rhythm two weeks after cardioversion.
authors.affiliation: Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario.
authors.forename: Luís
authors.initials: L
authors.lastname: Beck-da-Silva
authors.forename: Adolfo
authors.initials: A
authors.lastname: de Bold
authors.forename: Margaret
authors.initials: M
authors.lastname: Fraser
authors.forename: Kathryn
authors.initials: K
authors.lastname: Williams
authors.forename: Haissam
authors.initials: H
authors.lastname: Haddad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000378:metabolism*; D009864:Ontario; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain