title: Baseline NT-Pro-BNP levels and arrhythmia recurrence in outpatients undergoing elective cardioversion of persistent atrial fibrillation: a survival analysis.
abstract: BACKGROUND
  Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Elective electrical cardioversion is often performed in patients with persistent AF to attempt sinus rhythm (SR) restoration. However, AF recurrences are frequent after successful cardioversion and several predictors have been identified.
  
  
  OBJECTIVE
  The present study was designed to prospectively analyse the correlation between NT-pro-BNP levels and AF recurrence in consecutive patients referred for electrical cardioversion of persistent atrial fibrillation.
  
  
  RESULTS
  Forty consecutive patients referred for elective cardioversion of AF were enrolled in the study. Cardioversion restored sinus rhythm in 34/40 patients but 2 of them presented an early recurrence of AF before discharge. Patients were then followed for 6 months to assess AF recurrence. Cox regression analysis was performed using the parameters found predictive on univariate survival analysis (NT-pro-BNP quartiles, beta-blockers). The only independent predictor of AF recurrence on Cox-regression analysis was a level of NT-pro-BNP in the fourth quartile (HR 3.21 95%CI 1.26-8.14, p=0.014). On receiver operating curve (ROC) analysis, NT-pro-BNP levels above 1707 pg/ml had a specificity of 92% (and a sensitivity of 36%) in predicting atrial fibrillation recurrence by 6 months.
  
  
  CONCLUSIONS
  Baseline NT-pro-BNP levels are an independent predictor of AF recurrence at 6 months follow-up in candidates for elective direct current cardioversion.
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Sanna
authors.forename: Andrea
authors.initials: A
authors.lastname: Sonaglioni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pieroni
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.forename: Gemma
authors.initials: G
authors.lastname: Pelargonio
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.forename: Evelina
authors.initials: E
authors.lastname: Zichichi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Torre
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Narducci
authors.forename: Fulvio
authors.initials: F
authors.lastname: Bellocci