title: Red blood cell distribution width and atrial fibrillation in patients with sick sinus syndrome.
abstract: Sick sinus syndrome (SSS) is associated with atrial fibrillation (AF). Red blood cell distribution width (RDW) is a marker of anisocytosis of erythrocytes and is related to inflammatory stress. Recently, RDW has been associated with AF. The aim of the present study was to evaluate the potential association of RDW with AF history in patients with SSS.
  
  
  
  Consecutive patients with symptomatic SSS undergoing dual-chamber pacemaker implantation were screened. Baseline clinical, laboratory, echocardiographic, and electrocardiographic parameters were recorded. Conventional inflammatory indexes were also assessed. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis for parameters associated with AF were performed.
  
  
  
  The final study population consisted of 101 patients (47 men); median age: 77 [73-82] years. The demographic and clinical characteristics were comparable between tachy-brady (AF history) patients (n=32) and patients with other forms of SSS (n=69). Left atrial diameter was increased in tachy-brady patients [44 (39-48)mm vs. 39 (36-44)mm; p=0.05]. Also, the RDW was greater in these patients [14.7 (13.6-15.4)% vs. 13.7 (13.4-14.3)%; p=0.02]. Multivariate analysis showed that RDW is independently associated with AF (OR: 1.58; 95% CI: 1.06-2.85; p=0.04). The ROC curve analysis showed that the area under the curve was 0.69 (p=0.028). A RDW cut-off point of 14 was related to AF with a sensitivity of 70% and a specificity of 69%.
  
  
  
  RDW is associated with AF history in patients with SSS. The prognostic value of RDW in terms of future AF development and arrhythmia perpetuation in these patients should be further examined.
authors: First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece. Electronic address: p.korantzopoulos@yahoo.gr.
authors: Panagiotis
authors: P
authors: Korantzopoulos
authors: First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
authors: Konstantinos
authors: K
authors: Kyrlas
authors: Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China.
authors: Tong
authors: T
authors: Liu
authors: Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China.
authors: Guangping
authors: G
authors: Li
authors: First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
authors: John A
authors: JA
authors: Goudevenos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012804:Sick Sinus Syndrome / Q000097:blood* / Q000150:complications
chemical_list: D015415:Biomarkers
keywords: Atrial fibrillation; Red cell distribution width; Sinus node disease; Tachy-brady syndrome