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European Journal of Heart Failure 2002 4(3):263-267; doi:10.1016/S1388-9842(02)00004-1
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© 2002 European Society of Cardiology

Short-term effects of sinus rhythm restoration in patients with lone atrial fibrillation: a hormonal study

P. Jourdaina,*, M. Bellorinia, F. Funcka, Y. Fullab, N. Guillarda, J. Loireta, B. Thebaulta, N. Sadegd and M. Desnosc

a Service de Cardiologie Hôpital René Dubos, 6 avenue de l'Ile de France, 95300 Pontoise, France
b Service de Médecine Nucléaire Hôpital Cochin, 27 boulevard Saint Jacques, 75014 Paris, France
c Service de cardiologie Hôpital Européen G. Pompidou, Rue Leblanc, 75015 Paris, France
d Service de Biochimie Hôpital René Dubos, 6 avenue de l'Ile de France, 95300 Pontoise, France

* Corresponding author. Tel.: +33-1-30-75-41-86; fax +33-1-30-75-44-28. E-mail address: patrickjourdain{at}hotmail.com


  Abstract

It is well known that atrial fibrillation can lead to heart failure, and is attributed to rapid ventricular rate (tachycardia-induced cardiomyopathy). Some recent studies suggest the possible existence of an intrinsic left-ventricular factor related to atrial fibrillation, irrespective of other elements. In order to demonstrate the implication of this factor, we measured B-type Natriuretic Peptide, known as a functional marker of left-ventricular dysfunction, in 40 consecutive patients with chronic non-valvular atrial fibrillation, with low ventricular rate and absence of clinical heart failure or echocardiographic left-ventricular dysfunction. In all patients, Brain Natriuretic Peptide (BNP) plasma level was high and dramatically decreased 24 h after external electrical cardioversion (61.4 pg/ml before cardioversion, 23.5 pg/ml 1 day after cardioversion, P<0.002). Our study demonstrates that atrial fibrillation, in absence of high ventricular rate, induces an asymptomatic cardiac alteration that is not detectable by echocardiography.

Key Words: Cardioversion • Natriuretic peptides • Atrial fibrillation

Received January 11, 2001; Revised August 14, 2001; Accepted December 14, 2001


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