High-Sensitivity Troponin I and Rhythm Outcome after Electrical Cardioversion for Persistent Atrial Fibrillation

作者：Horjen Anja Wiedswang; Ulimoen Sara Reinvik; Seljeflot Ingebjorg; Smith Pal; Arnesen Harald; Norseth Jon; Tveit Arnljot

来源：Cardiology, 2016, 133(4): 233-238.

DOI：10.1159/000442249

• Atrial fibrillation
• Cardioversion
• High-sensitivity troponin 1
• Angiotensin II type 1 receptor blocker

Objectives: We hypothesised that high-sensitivity troponin I (hs-Tnl) 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-Tnl 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-Tnl. 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/I, respectively; p = 0.699). Conclusions: hs-Tn1 did not predict AF recurrence after cardioversion. hs-Tnl levels were unchanged in patients maintaining sinus rhythm for 6 months after electrical cardioversion. hs-Tnl levels were not influenced by treatment with candesartan.

• 出版日期2016