title: The dubious value of echocardiographic and plasma ANP measurements in predicting outcome of cardioversion in patients with persistent atrial fibrillation.
abstract: Atrial fibrillation (AF) is a common arrhythmia with important therapeutic and prognostic implications. An attempt to restore sinus rhythm is considered in most patients with AF. The aim of this study was to assess the value of echocardiographic examination and plasma atrial natriuretic peptide (ANP) evaluation in predicting the outcome of cardioversion and maintenance of sinus rhythm in patients with persistent AF.
  
  
  METHODS
  Eighty-one consecutive patients, aged 62+/-9 years, with AF of duration 4.7 months were subjected to an echocardiography examination and ANP assessment before cardioversion. The patients were predominantly hypertensive men with moderately enlarged left atrium and ejection fraction of left ventricle of about 50%. All patients were in controlled AF and had normalized blood pressure. In order to predict the outcome of cardioversion, and maintenance of sinus rhythm over a 1 month period, a multivariate logistic regression method was performed using the following variables: left atrial and left ventricular dimensions, left ventricular ejection fraction and plasma ANP levels.
  
  
  RESULTS
  Sixty-nine out of the 81 patients were successfully converted to sinus rhythm. At 1 month 57 patients remained in sinus rhythm. There were no statistical differences between sinus rhythm and AF group in baseline ANP levels (59.4 vs 64.2 pg/ml, consecutively), clinical and echocardiographic characteristics. In logistic regression analysis neither baseline echocardiographic variable nor ANP level, predicts successful cardioversion over a 1-month period of observation.
  
  
  CONCLUSIONS
  Echocardiographic data and ANP level should not be included as an important variable when considering patients for cardioversion.
authors.affiliation: Department of Cardiology, Regional District Hospital, Kielce, Poland. energo_kap@poczta.onet.pl
authors.forename: Beata
authors.initials: B
authors.lastname: Wozakowska-Kapłon
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000628:therapy*; D009320:Atrial Natriuretic Factor / Q000097:blood*; D004353:Drug Evaluation, Preclinical; D004554:Electric Countershock; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D009320:Atrial Natriuretic Factor