title: Acute effect of zoledronic acid infusion on atrial fibrillation development in patients with osteoporosis.
abstract: OBJECTIVE
  There is ongoing controversy related to the relationship between bisphosphonates and atrial fibrillation (AF). Our aim in this study was to evaluate the potential acute effect of zoledronic acid (ZA) infusion on AF development by using 24-hour Holter recordings.
  
  
  METHODS
  The study was designed to be a self-controlled case series study, and 33 consecutive patients with osteoporosis (29 females, age: 62.3±9.0 years) who were scheduled to receive ZA infusion constituted the study population. Patients underwent 24-hour Holter rhythm recordings at two different times; the first one was 48 hours before the planned ZA infusion, and the second one was on the morning of the infusion day. Heart rate, frequency and type of arrhythmias, as well as heart rate variability (HRV) from the two recordings were compared.
  
  
  RESULTS
  There were no episodes of AF greater than 30 sec in any of the 24-hour Holter recordings obtained before and on the day of drug infusion. Holter recordings before drug infusion showed that only 1 patient had an atrial run of 3 beats long. Holter recordings obtained on the day of drug infusion revealed that 5 patients (15.2%) had atrial runs with lengths ranging between 3 and 12 beats (p=0.046). Regarding HRV variables, SDANN values were found to be significantly depressed on the day of ZA infusion (113.6±26.9 vs. 98.2±29.9, p=0.007).
  
  
  CONCLUSIONS
  None of the patients developed AF during or early after ZA infusion. However, there was an increase in atrial ectopy in some patients, which might be due to alterations in cardiac autonomic activity.
authors.affiliation: Clinic of Cardiology, Fatih Sultan Mehmet Training and Research Hospital; İstanbul-Turkey. zeynepdemet@gmail.com.
authors.forename: Zeynep Demet
authors.initials: ZD
authors.lastname: İlgezdi
authors.forename: İlknur
authors.initials: İ
authors.lastname: Aktaş
authors.forename: Fatma
authors.initials: F
authors.lastname: Doğan Metin
authors.forename: Alper
authors.initials: A
authors.lastname: Kepez
authors.forename: Feyza
authors.initials: F
authors.lastname: Ünlü Özkan
authors.forename: Ayşe Duygu
authors.initials: AD
authors.lastname: Şilte
authors.forename: Meryem
authors.initials: M
authors.lastname: Yılmaz Kaysın
authors.forename: Tarık
authors.initials: T
authors.lastname: Kıvrak
authors.forename: Altuğ
authors.initials: A
authors.lastname: Çincin
authors.forename: Okan
authors.initials: O
authors.lastname: Erdoğan
mesh_terms: D001281:Atrial Fibrillation / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004164:Diphosphonates / Q000008:administration & dosage* / Q000009:adverse effects; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006620:Hip Fractures / Q000517:prevention & control*; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D007262:Infusions, Intravenous; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal; D000077211:Zoledronic Acid
chemical_list: D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid