Sinus rhythm restoration after atrial fibrillation: the clinical value of N-terminal pro-BNP measurements.
OBJECTIVE
To examine the effects of sinus rhythm (SR) restoration on N-Terminal pro-BNP (NTP-BNP) in patients with atrial fibrillation (AF).


METHODS
Subjects with paroxysmal and persistent AF and absence of organic heart disease were prospectively studied. Chemical or electrical restoration of SR was attempted within 48 hours (n = 37) or >3 weeks (n = 73). Clinical and laboratory (NTP-BNP, 72-hour Holter monitor, and electrocardiogram) assessment were obtained at baseline and at 1, 30, and 180 days after SR restoration. Patients were divided into three predefined "outcome groups": (a) maintenance of SR for 1 month, (b) SR with recurrent paroxysmal AF (PaAF), and (c) early (<30 days) recurrence persistent AF (RAF).


RESULTS
Of the 110 patients enrolled, 89 had initial successful SR restoration. Baseline NTP-BNP was 936 pg/mL (interquartile range (IQR) 333-2,026); ratio between baseline and 30-day NTP-BNP was 10.2 (IQR 6.42-22.0) for SR group, 3.3 (IQR 2.45-7.34) for PaAF, and 1.07 (IQR 0.87-1.22) for RAF (P < 0.001). Patients with ratio </=3 were more likely to have PaAF (46% vs 3%, OR 30, P < 0.001).


CONCLUSIONS
With SR restoration, NTP-BNP decline is observed up to 1 month. NTP-BNP drop is partially or completely abolished by PaAF and RAF, respectively. NTP-BNP does not predict successful SR restoration.
Danicek
Vladimir
V
Department of Cardiology, Assaf Harofeh Medical Center and Sackler School of Medicine, Tel Aviv, Tel Aviv, Israel.
Theodorovich
Nick
N
Bar-Chaim
Shmuel
S
Miller
Asaf
A
Vered
Zvi
Z
Koren-Morag
Nira
N
Uriel
Nir
N
Czuriga
Istvan
I
Shopen
Andrey
A
Brantriss
Nurit
N
Kaluski
Edo
E
D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain