title: Sinus rhythm restoration after atrial fibrillation: the clinical value of N-terminal pro-BNP measurements.
abstract: 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.
authors.affiliation: Department of Cardiology, Assaf Harofeh Medical Center and Sackler School of Medicine, Tel Aviv, Tel Aviv, Israel.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Danicek
authors.forename: Nick
authors.initials: N
authors.lastname: Theodorovich
authors.forename: Shmuel
authors.initials: S
authors.lastname: Bar-Chaim
authors.forename: Asaf
authors.initials: A
authors.lastname: Miller
authors.forename: Zvi
authors.initials: Z
authors.lastname: Vered
authors.forename: Nira
authors.initials: N
authors.lastname: Koren-Morag
authors.forename: Nir
authors.initials: N
authors.lastname: Uriel
authors.forename: Istvan
authors.initials: I
authors.lastname: Czuriga
authors.forename: Andrey
authors.initials: A
authors.lastname: Shopen
authors.forename: Nurit
authors.initials: N
authors.lastname: Brantriss
authors.forename: Edo
authors.initials: E
authors.lastname: Kaluski
mesh_terms: 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
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain