학술논문

Sinus Rhythm Restoration after Atrial Fibrillation: The Clinical Value of N-Terminal Pro-BNP Measurements.
Document Type
Article
Source
Pacing & Clinical Electrophysiology. Aug2008, Vol. 31 Issue 8, p955-960. 6p. 1 Diagram, 2 Charts, 1 Graph.
Subject
*ATRIAL fibrillation
*PAROXYSMAL tachycardia
*HEART diseases
*AMBULATORY electrocardiography
*HEART failure
*HEART atrium
Language
ISSN
0147-8389
Abstract
Aim: To examine the effects of sinus rhythm (SR) restoration on N-Terminal pro-BNP (NTP-BNP) in patients with atrial fibrillation (AF). Methods: Subjects with paroxysmal and persistent AF and absence of organic heart disease were prospectively studied. Chemical or electrical restoration of SR was attempted within 48 hours (n = 37) or >3 weeks (n = 73). Clinical and laboratory (NTP-BNP, 72-hour Holter monitor, and electrocardiogram) assessment were obtained at baseline and at 1, 30, and 180 days after SR restoration. Patients were divided into three predefined “outcome groups”: (a) maintenance of SR for 1 month, (b) SR with recurrent paroxysmal AF (PaAF), and (c) early (<30 days) recurrence persistent AF (RAF). Results: Of the 110 patients enrolled, 89 had initial successful SR restoration. Baseline NTP-BNP was 936 pg/mL (interquartile range (IQR) 333–2,026); ratio between baseline and 30-day NTP-BNP was 10.2 (IQR 6.42–22.0) for SR group, 3.3 (IQR 2.45–7.34) for PaAF, and 1.07 (IQR 0.87–1.22) for RAF (P < 0.001). Patients with ratio ≤3 were more likely to have PaAF (46% vs 3%, OR 30, P < 0.001). Conclusion: With SR restoration, NTP-BNP decline is observed up to 1 month. NTP-BNP drop is partially or completely abolished by PaAF and RAF, respectively. NTP-BNP does not predict successful SR restoration. [ABSTRACT FROM AUTHOR]