[Relationship between C-reactive protein level and early recurrence of atrial fibrillation after electrical cardioversion].
OBJECTIVE
Atrial remodeling is responsible for the early recurrence of atrial fibrillation (AF) after cardioversion. Recently, it has been shown that the C-reactive protein (CRP) level is elevated in patients with AF, indicating that inflammation may play a role in the pathogenesis of this arrhythmia. We postulated that a high CRP level would predict early recurrence of AF after electrical cardioversion.


METHODS
Forty-two patients with persistent AF, but without known heart disease, who underwent elective electrical cardioversion were investigated. The CRP level was measured immediately before cardioversion. The study population comprised the 37 patients in whom sinus rhythm was restored.


RESULTS
After a follow-up period of 30 days, 16 patients (43%) had recurrence of AF; the other 21 (57%) remained in sinus rhythm. The mean CRP level was significantly higher in patients with AF recurrence (6.3 [3.3] mg/L vs 2.4 [2.1] mg/L, P=.0001). On dividing patients according to whether their CRP level was < or =3 mg/L or >3 mg/L, it was observed that only 33% of those in sinus rhythm had a level >3 mg/L compared with 81% of those with AF recurrence (P=.004). Patients with a CRP level >3 mg/L had a significant increase in the 1-month risk of AF recurrence (RR=3.7; 95% CI, 1.3-10.8). There was no association between CRP level and left atrial diameter (P =.50) or AF duration (P=.458).


CONCLUSIONS
A high CRP level is associated with early recurrence of AF after electrical cardioversion, suggesting that inflammation could play a role in atrial remodeling.
Zarauza
Jesús
J
Servicio de Cardiología, Hospital Sierrallana, Torrelavega, Cantabria, España. jzarauza@hsll.scsalud.es
Rodríguez Lera
María J
MJ
Fariñas Alvarez
Concepción
C
Hernando
Juan P
JP
Ceballos
Begoña
B
Gutiérrez
Benedicto
B
Pérez
Josefina
J
Cuesta
José M
JM
D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000209:etiology; D016275:Atrial Function; D002097:C-Reactive Protein / Q000032:analysis*; D016009:Chi-Square Distribution; D003627:Data Interpretation, Statistical; D004554:Electric Countershock; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors
D002097:C-Reactive Protein