title: High-Sensitivity Troponin I and Rhythm Outcome after Electrical Cardioversion for Persistent Atrial Fibrillation.
abstract: OBJECTIVE
  We hypothesised that high-sensitivity troponin I (hs-TnI) might predict long-term rhythm outcome after cardioversion for persistent atrial fibrillation (AF), and that maintenance of sinus rhythm and/or treatment with the angiotensin II type 1 receptor blocker candesartan would reduce hs-TnI levels.
  
  
  METHODS
  In a double-blind, placebo-controlled study, 171 patients referred for electrical cardioversion for AF were randomised to receive candesartan or placebo for 3-6 weeks before cardioversion and for 6 months after electrical cardioversion. Blood samples for analysis of hs-TnI (Abbott Diagnostics) were available in 129 patients at baseline and in 60 successfully cardioverted patients at study end.
  
  
  RESULTS
  Hs-TnI was detectable in all subjects, with a median value of 5.3 ng/l (25th percentile 3.7, 75th percentile 7.2). hs-TnI at baseline was not predictive of rhythm outcome 6 months after electrical cardioversion for persistent AF. Treatment with candesartan did not influence the levels of hs-TnI. hs-TnI was unchanged from baseline to study end in patients who maintained sinus rhythm [4.9 (3.7, 7.0) and 5.0 (4.0, 6.4) ng/l, respectively; p = 0.699).
  
  
  CONCLUSIONS
  hs-TnI did not predict AF recurrence after cardioversion. hs-TnI levels were unchanged in patients maintaining sinus rhythm for 6 months after electrical cardioversion. hs-TnI levels were not influenced by treatment with candesartan.
authors.affiliation: Department of Medical Research, Vestre Viken Hospital Trust, Bx00E6;rum Hospital, Drammen, Norway.
authors.forename: Anja Wiedswang
authors.initials: AW
authors.lastname: Horjen
authors.forename: Sara Reinvik
authors.initials: SR
authors.lastname: Ulimoen
authors.forename: Ingebjørg
authors.initials: I
authors.lastname: Seljeflot
authors.forename: Pål
authors.initials: P
authors.lastname: Smith
authors.forename: Harald
authors.initials: H
authors.lastname: Arnesen
authors.forename: Jon
authors.initials: J
authors.lastname: Norseth
authors.forename: Arnljot
authors.initials: A
authors.lastname: Tveit
mesh_terms: D000367:Age Factors; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000097:blood* / Q000628:therapy*; D001562:Benzimidazoles / Q000627:therapeutic use; D001713:Biphenyl Compounds; D001794:Blood Pressure; D004311:Double-Blind Method; D004554:Electric Countershock; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012737:Sex Factors; D013777:Tetrazoles / Q000627:therapeutic use; D019210:Troponin I / Q000097:blood*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; D019210:Troponin I; C081643:candesartan