title: Atorvastatin given prior to electrical cardioversion does not affect the recurrence of atrial fibrillation in patients with persistent atrial fibrillation who are on antiarrhythmic therapy.
abstract: OBJECTIVE
  In this study, our aim was to evaluate the effect of a higher dose of atorvastatin on the recurrence rate of atrial fibrillation (AF) after electrical cardioversion (EC) in addition to antiarrhythmic therapy.
  
  
  METHODS
  48 patients with persistent AF were included in this study. The patients were randomized to an atorvastatin 40-mg treatment group and a control group. Atorvastatin was started 3 weeks before EC and was continued for 2 months after EC. EC was performed using biphasic shocks after 3 weeks of treatment with the orally administered anticoagulant warfarin. Lipid and inflammatory parameters (high-sensitivity C-reactive protein, white blood cell count and fibrinogen level) were evaluated at the baseline and before EC. The endpoint of this study was electrocardiographically confirmed recurrence of AF of >10 min.
  
  
  RESULTS
  There were no significant differences in baseline characteristics and lipid and inflammatory marker levels between the treatment and control groups. Total cholesterol and low-density lipoprotein levels were significantly decreased in patients taking atorvastatin for 2 months compared with baseline values (174 ± 31 vs. 129 ± 25 mg/dl, p = 0.001, and 112 ± 23 vs. 62 ± 20 mg/dl, p = 0.001, respectively), while no significant change occurred in control patients (168 ± 26 vs. 182 ± 29 mg/dl, p = 0.07, and 99 ± 18 vs. 108 ± 26 mg/dl, p = 0.1, respectively). At the end of the 2-month follow-up period, 9 patients (20.5%) experienced AF recurrence, and there was no significant difference in AF recurrence rate between the treatment and control groups (26 vs. 13%; p = 0.2).
  
  
  CONCLUSIONS
  Atorvastatin therapy prior to EC does not prevent the recurrence of arrhythmia in patients with persistent AF who are receiving antiarrhythmic therapy.
authors.affiliation: Department of Cardiology, School of Medicine, Selcuk University, Tokat, Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Demir
authors.forename: Ilknur
authors.initials: I
authors.lastname: Can
authors.forename: Fatih
authors.initials: F
authors.lastname: Koc
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Vatankulu
authors.forename: Selim
authors.initials: S
authors.lastname: Ayhan
authors.forename: Hakan
authors.initials: H
authors.lastname: Akilli
authors.forename: Alpay
authors.initials: A
authors.lastname: Aribas
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Alihanoglu
authors.forename: Bulent Behlul
authors.initials: BB
authors.lastname: Altunkeser
mesh_terms: D000704:Analysis of Variance; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D000069059:Atorvastatin; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000473:pathology / Q000517:prevention & control*; D002097:C-Reactive Protein; D002908:Chronic Disease; D004554:Electric Countershock / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006305:Health Status Indicators; D006538:Heptanoic Acids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage* / Q000627:therapeutic use; D055502:Secondary Prevention; D013997:Time Factors; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000889:Anti-Arrhythmia Agents; D000924:Anticholesteremic Agents; D000925:Anticoagulants; D006538:Heptanoic Acids; D011758:Pyrroles; D014859:Warfarin; D005340:Fibrinogen; D002097:C-Reactive Protein; D000069059:Atorvastatin