Recurrence of atrial fibrillation after successful electrical cardioversion in patients with persistent atrial fibrillation can be predict by hjgher levels of hs-CRP

Inflammation has been associated with genesis of atrial fibrillation and higher hs-CRP levels with a more resistant arrhythmia to cardioversion. Since 2002, omega-3 fatty acids were correlated to anti-fibrillatory effects and they can reduce levels of hs-CRP. The aim of this study was to establish if levels of hs-CRP can predict the beneficial effects of electrical cardioversion in patients (pts) with nonvalvular persistent atrial fibrillation (pAF) and if these levels can explain a stable sinus rhythm during treatment with omega-3 fatty acids. Materials and methods. 26 pts with pAF, mean age (age 67±09 years; 14 men) underwent a basal determination of hs-CRP during the week preceding cardioversion and a transesophageal echocardiogram in the same day of the attempted cardioversion. Pts whose cardioversion was successful, entered a 6-month follow-up. Each pt in stable sinus rhythm during the follow-up period was randomized to 1 g/day of omega-3 fatty acids or to placebo, plus the common therapy with amiodarone and SRA antagonists. Results. 10 pts maintained pAF (Table 1). The remaining 16 were successfully cardioverted and divided into two subgroups: omega-3 and placebo (Table 2). Before cardioversion, no significant differences were found between pts. During the follow-up, the omega-3 group showed lower levels of hs-CRP and no episode of recurrent AF, while in the placebo group 5 out of 6 pts had AF and higher levels of hs-CRP.