Prognostic value of left atrial expansion index and exercise-induced change in atrial natriuretic peptide as long-term predictors of atrial fibrillation recurrence.
OBJECTIVE
We propose to assess the value of exercise-induced change in N-terminal-pro atrial natriuretic peptide (NT-proANP) and left atrial expansion index (LAEI) in predicting AFR after cardioversion and their effect on AF-free survival.


RESULTS
Fifty-five patients with persistent AF of <18 months duration needing cardioversion were recruited for the study. Fifty-four patients were successfully cardioverted. At 3 months 28/54 (51%) were in SR and at 12 months 21/53 (39%). On multivariate analysis, only exercise-induced change in NT-proANP and LAEI were found to be predictive of AFR up to 12 months post-cardioversion and had an effect on AF-free survival. N-terminal-pro brain natriuretic peptide was elevated in all persistent AF patients but did not predict recurrent AF.


CONCLUSIONS
Left atrial expansion index and exercise-induced atrial natriuretic peptide change show promise as predictors of AFR after cardioversion. These predictors may identify patients at an early stage in their disease with intact neurohumoral feedback systems and less advanced atrial remodelling. Further studies are required to confirm these findings.
Division of Cardiac and Vascular Sciences, St George's University of London, London SW17 0RE, UK. mgovinda@sgul.ac.uk
Malini
M
Govindan
Gabor
G
Borgulya
Anatoli
A
Kiotsekoglou
Samir K
SK
Saha
A John
AJ
Camm
D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D009320:Atrial Natriuretic Factor / Q000097:blood*; D018572:Disease-Free Survival; D004554:Electric Countershock; D004562:Electrocardiography; D015444:Exercise; D005260:Female; D006325:Heart Atria / Q000033:anatomy & histology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009929:Organ Size; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome
D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor