Objective: To assess the inflammatory state in patients with persistent atrial fibrillation and to determine the predictive value in the success of cardioversion and recurrence at 30 days.
Design: Prospective observational case-control study.
Patients: We included consecutively 49 patients with atrial fibrillation previously to scheduled electrical cardioversion in Coronary Care Unit. Clinical and echocardiographic variables were registered and High-sensivity C-reactive protein, interleukin-1beta, interleukin-6 and Tumour Necrosis Factor-alpha were measured. At 30-days follow-up, rhythm and biomarkers were reassessed. As control groups, we recruited 27 healthy volunteers and 16 patients matched for age, gender and cardiovascular risk factors.
Results: Median age was 66 +/- 10 years and 38% were women. All the markers were higher in patients than in both control groups (p < 0.05). FNT-alpha and Interleukin-6 levels were higher in non-cardiovertors but only an enlarged atria was related to unsuccessful cardioversion (p = 0.036). High-sensivity C-reactive protein values in the higher cuartile tended to be related to recurrence of persistent atrial fibrillation (p = 0.06).
Conclusions: There is an increased inflammatory state in patients with atrial fibrillation. FNT-alpha and Interleukin-6 levels were increased in non-cardiovertors, but no biomarker was associated with success of cardioversion or rhythm state at 30-days. However, higher levels of hs-CRP showed a trend to be related to recurrence of atrial fibrillation.