肥厚型心肌病合并心房颤动导管消融术后复发的相关因素分析

目的 探讨国人肥厚型心肌病(HCM)合并心房颤动(房颤)患者导管消融术的疗效及术后心律失常复发的危险因素.方法 纳入2005年6月至2013年6月在北京安贞医院行导管消融术的HCM合并房颤患者共40例(阵发性房颤27例,持续性房颤13例).阵发性房颤的消融策略为双侧环肺静脉隔离(PVI)持续性房颤的消融策略为PVI基础上加行左心房顶部、二尖瓣峡部和三尖瓣峡部线性消融.术后以常规心电图和长程心电图随访患者心律失常复发情况,用回归分析方法甄别与心律失常复发相关的危险因素并检测其预测效力.结果 单次消融术后随访(34±18)个月,窦性心律维持率为30％ (12/40),64.3％ (18/28)的心律失常复发出现在消融术后1年.Cox多因素分析显示左心房内径(LAD)和女性是术后快速房性心律失常复发的独立危险因素(LAD:HR=1.124,95％ CI1.051～1.202,P=0.001;女性:HR=3.304,95％CI1.397 ～7.817,P=0.007).其中LAD的截断值为43.5 mm时的预测敏感度为93.5％,特异度为60.0％;LAD每增加1 mm,心律失常复发的风险比为1.095(95％CI1.031～1.163,P=0.003).结论 HCM合并房颤行导管消融术虽安全可行,但单次手术后长期随访的窦性心律维持率较低,大部分心律失常复发出现在术后1年内,左心房内径增大和女性是术后复发的独立危险因素.     

持续性心房颤动电复律术后近期复发的影响因素

目的探讨持续性心房颤动(简称房颤)电复律术后近期复发的预测因素,并初步探讨其临床意义。方法62例行电复律的持续性房颤患者,分析患者的年龄、性别、病史、左房大小、P波终末电势(PtfV1)、二尖瓣狭窄程度、左室射血分数、左房射血力、VE/VA、合并高血压与电转复术后2个月内复发的关系。结果62例电复律后2个月内复发22例,复发率35.5%,单因素分析示电转复后左房扩大、二尖瓣狭窄、PtfV1异常与房颤近期复发显著相关,多因素逻辑回归分析结果只有左房扩大是电转复术后持续性房颤复发的独立危险因素。结论左房扩大是持续性房颤电复律术后复发的独立危险因素,二尖瓣狭窄及PtfV1异常使持续性房颤电复律术后的近期复发率增高。     

心房颤动环肺静脉消融术后复发的预测因素

目的探讨心房颤动(简称房颤)环肺静脉消融术(CPVA)后复发的预测因素。方法109例接受CPVA治疗的房颤患者,在三维电解剖标测系统(CARTO)指导下行环绕同侧肺静脉的线性消融,消融终点为肺静脉电隔离(PVI)。通过对10项临床和消融过程指标进行分析,确定单次CPVA术后早期(<3个月)复发和晚期(≥3个月)复发的预测因素。结果所有患者均实现消融终点,其中59例为通过单一CPVA法(简称强化CPVA法)实现PVI,50例为通过CPVA联合肺静脉口节段性消融法(简称改良CPVA法)实现PVI。49例(45.0%)在术后早期复发房性快速心律失常(ATa)。单因素分析显示左房增大、合并器质性心脏病和改良CPVA法是术后早期复发的预测指标;但经多因素分析后仅有改良CPVA是独立的预测指标(P<0.001;RR4.670;95%CI1.996~10.927)。随访9.1±3.5(4~15)个月,33例(30.3%)在术后晚期复发ATa。单因素分析显示左房增大、合并器质性心脏病和改良CPVA同时也是晚期复发的预测指标,但亦仅有改良CPVA是经多因素分析确定的独立预测指标(P=0.036;RR0.391;95%CI0.613~0.941)。严重并发症包括1例心脏压塞和1例脑卒中。结论在以PVI作为房颤CPVA治疗的消融终点时,无论是术后早期复发或晚期复发,改良CPVA法均是其独立的预测因素。     

已达到消融终点的长程持续性心房颤动复发危险因素分析

目的：探讨已达到消融终点的长程持续性心房颤动（房颤）患者复发的危险因素。方法：纳入达到消融终点的长程持续性房颤患者256例,消融终点定义为双侧肺静脉电隔离,二尖瓣峡部和左心房顶部线性消融双向阻断且碎裂电位消失。根据随访结果将患者分为房颤复发组（n＝43）和无复发组（n＝213）。通过多因素 COX 回归分析探讨房颤复发的独立危险因素。结果：经过（19．5±3．6）个月随访,与无复发组相比,房颤复发组患者右心房内径较大,为（53．31±6．55）mm 对（48．74±5．87）mm;房颤持续时间较长,为（81．83±45．75）个月对（53．16±40．23）个月;左心房内径较大,为（49．85±6．82）mm 对（46．77±5．83）mm,P 均＜0．01。多因素 COX 回归分析发现,左心房内径增大（OR＝1．01,95％CI：1．01～1．28,P ＜0．05）,右心房内径增大（OR＝2．85,95％CI：1．15～7．03,P ＜0．05）、房颤持续时间延长（OR＝1．01,95％CI：1．01～1．02,P ＜0．05）是房颤复发的独立危险因素。结论：除左心房内径和房颤持续时间外,右心房内径增大也是已达到消融终点的长程持续性房颤复发的独立危险因素。     

阵发性心房颤动局灶性消融治疗后复发的危险因素与预测

目的　确定阵发性心房颤动 (房颤 )局灶性消融治疗后复发的危险因素与预测因子。方法　连续 74例接受局灶性消融治疗的阵发性房颤 ,通过单因素和多因素分析对 11项临床和射频消融指标与房颤复发之间的关系进行研究。结果　平均随访 (12 4± 6 6 )个月 ,5 1例 (6 8 9% )房颤复发。单因素分析确定的与复发有关的因素包括 :年龄 [(5 3 0± 13 9)对 (4 5 0± 11 6 )岁 ,P <0 0 5 ]、左心房前后径 [(39± 5 )对 (36± 3)mm ,P =0 .0 1]、异位灶数目 [(1.6± 0 .7)对 (1.2± 0 .4)个 ,P <0 .0 1]和总X线透视时间 [(4 3± 9)对 (38± 9)min ,P <0 0 5 ]等 4种 ;但经Logistic多因素逐步回归分析后仅有异位灶数目 (OR 3 7;95 %CI 1 2～ 11 1;P <0 0 5 )和左心房前后径 (OR 1 2 ;95 %CI 1 0～ 1 4;P <0 0 5 )为消融后复发的独立预测因子。结论　多异位灶起源和左心房增大是阵发性房颤局灶性消融后复发的独立预测因素     

典型心房扑动对心房颤动导管消融复发的影响

目的 评价典型心房扑动(房扑)对心房颤动(房颤)导管消融复发的影响.方法 120例药物治疗无效的阵发性房颤患者在三维电解剖标测系统和肺静脉环状标测电极导管联合指导下行环肺静脉电隔离.其中17例(14.2%)合并典型房扑(房扑组,其余作为对照组),行三尖瓣环峡部消融,三尖瓣环峡部消融终点为三尖瓣环峡部双向阻滞.房颤复发定义为导管消融3个月后发生房性快速心律失常.结果 房扑组房颤病程(9.8±10.7)年,长于对照组(5.9±6.3)年,差异有统计学意义(P=0.036).房扑组与对照组相比,年龄、性别、合并器质性心脏病、左心房直径、左心室射血分数差异无统计学意义.随访91～401(237±79)d,房扑组房颤复发率为47.1%,对照组房颤复发率为12.6%,两组间差异有统计学意义(P=0.001).经校正年龄、房颤病程、合并器质性心脏病、左心房直径等因素,Cox多因素分析发现消融术前合并房扑是房颤复发的独立危险因素(危险比3.52,95%可信区间1.32～9.34,P=0.012).结论 典型房扑可能增加房颤导管消融术后房颤的复发,房颤导管消融前应对患者是否合并典型房扑进行认真评价.     

Predictors of success and effect of biphasic energy on electrical cardioversion in patients with persistent atrial fibrillation.

AIMS: We sought predictors of successful electrical cardioversion (ECV) and the effect of biphasic energy in patients considered candidates for rhythm control. METHODS AND RESULTS: The patients were drawn from a registry, which included prospectively 1355 consecutive patients with persistent atrial fibrillation who underwent ECV in 96 Spanish hospitals. Successful ECV was considered excluding patients with an early relapse. Factors related to successful cardioversion were evaluated using logistic regression with the patients segregated with respect to the use of monophasic or biphasic energy. Sinus rhythm was restored in 92% of the patients, of which, 5% had an early relapse. Thus, we considered that a successful ECV was achieved in 87% of patients. Body surface area was the only factor independently related to failure of the monophasic energy cardioversion (OR = 0.20; P = 0.001). No single factor was predictive of biphasic energy cardioversion failure. Biphasic energy was more effective in restoring sinus rhythm in patients with body surface area >2.05 m(2) (83% success in monophasic vs. 92% in biphasic; P = 0.02). CONCLUSION: Body surface area was the only factor related to the success of ECV, but only in patients treated with monophasic energy. Biphasic energy should be the technique-of-choice in patients with a large body surface area.     

Long-short sequence may predict immediate recurrence of atrial fibrillation after external cardioversion.

AIM: We thought, that analysis of surface electrocardiograms recorded immediately after electrical external cardioversion (EC) might enlighten the mechanisms responsible for immediate recurrence of atrial fibrillation (AF) and especially to test whether atrial ectopic beats (PAC) with long-short (LS) sequence are related to the recurrence of arrhythmia after cardioversion in patients with chronic AF. METHODS AND RESULTS: One hundred and thirty-seven patients (mean age 57+/-7 years) undergoing EC for chronic AF entered the study. Evaluation of the patients included clinical history, physical examination, ECG, routine laboratory tests, and transthoracic echocardiography. The cardioversion was performed with monophasic waveform shock and immediately after successful EC, 1 min of recording of the ECG lead II was analysed. One hundred and twenty patients (87%) of 137 patients enrolled in the study had had successful EC and 33 (27%) of them experienced immediate recurrence of AF within 1 min (Group I) and 87 patients had no arrhythmia recurrence (Group II). In group I in 24 patients (73%) recurrence of AF was initiated by PAC with LS sequence. In only 12 of 87 (13%) patients who did not experience immediate recurrence of AF (Group II) PACs were recorded. CONCLUSIONS: Atrial ectopic beats (PACs) with LS sequence, being responsible for AF relapse in about 70% of patients, might predict early re-initiation of arrhythmia after EC. Electrocardiograms, recorded immediately after EC, are a potentially feasible approach in establishing the patterns of AF relapse that may be useful in the management of AF recurrence.     

Low-energy internal cardioversion in patients with long-lasting atrial fibrillation refractory to external electrical cardioversion: results and long-term follow-up.

AIM: Low-energy internal cardioversion is a new electrical treatment for patients with persistent atrial fibrillation. This paper evaluates the efficacy and safety of low-energy internal cardioversion in patients with long-lasting atrial fibrillation refractory to external electrical cardioversion, and the clinical outcome of such patients. METHOD AND RESULTS: The study population consisted of 55 patients [32 male, mean age 65 +/- 10 years, 48 (87%) with underlying heart disease] with long-lasting (mean 18 +/- 34 months) atrial fibrillation in whom external cardioversion had failed to restore sinus rhythm. Two custom-made catheters were used: one positioned in the right atrium and one in the coronary sinus or the left pulmonary artery. A standard catheter was inserted into the right ventricular apex to provide R wave synchronization. Sinus rhythm was restored in 52 patients (95%) with a mean defibrillating energy of 6.9 +/- 2.6 J (320 +/- 60 V). No complications were observed. During follow-up (mean 18 +/- 9 months), 16 patients (31%) suffered early recurrence (< or = 1 week) of atrial fibrillation and 20 patients (38%) had late recurrence (> 1 week, mean 3.5 +/- 3.6 months) of atrial fibrillation. Six patients with a late recurrence again underwent cardioversion and five of these maintained sinus rhythm. Therefore, a total of 21/52 patients (40%) were in sinus rhythm at the end of follow-up. No clinical difference was found between patients with and without recurrences. CONCLUSIONS: Low-energy internal cardioversion is a useful means of restoring sinus rhythm in patients with long-lasting atrial fibrillation refractory to external electrical cardioversion. More than one-third of patients maintained sinus rhythm during long-term follow-up.     

P波心电指标预测心房颤动首次射频导管消融术后复发的价值

目的：射频导管消融（ RFCA）是心房颤动（房颤）主要的治疗手段,然而关于RFCA术后房颤复发的预测指标较少。本研究探讨预测房颤首次RFCA术后复发的较为实用的心电学指标。方法对172例在2009年至2010年首次在大连医科大学附属第一医院二部行RFCA术的阵发性房颤患者进行随访研究。测量术前最大P波时限（ P-max）、最小P波时限（ P-min）、P波离散度（ PWD）、PR间期及V1导联P波终末电势（ PtfV1）,探讨PtfV1≥0．04 mV·s在预测首次行RFCA的阵发性房颤患者术后复发的价值。结果首次行RFCA患者分为复发组（57例）和未复发组（115例）。单因素分析显示心力衰竭、左心房内径、P-max、P-min、PtfV1≥0．04 mV·s与房颤复发显著相关,二元Logistic回归分析发现PtfV1≥0．04 mV·s是房颤复发的独立预测因素。 PtfV1≥0．04 mV·s与房颤的Kaplan-Meier曲线及ROC曲线均显示差异具有统计学意义。PtfV1≥0．04 mV·s对房颤复发预测的灵敏度为72．0%,特异度为73．9%。结论PtfV1≥0．04 mV·s能够很好地预测阵发性房颤首次RFCA术后复发,有一定的推广价值。     

心房颤动电转复后左心耳顿抑的预测因子

目的研究非瓣膜病心房颤动(房颤)患者中,心脏电转复后左心耳顿抑的危险因素与预测因子.方法 68例房颤电转复成功患者,分为左心耳顿抑组与对照组,通过单因素及多元逐步逻辑回归分析,将临床和超声影像学指标作为待选变量,对电转复后左心耳顿抑的危险因素进行研究.结果单因素分析发现,左心耳顿抑组与对照组间差异有统计学意义的指标有房颤持续时间[(10.6±15.6)周vs(22.0±20.1)周,P＜0.05]、左心房内径[(43.8±7.7)mm vs(48.5±6.2)mm,P＜0.01)]、左心房排空分数[(0.32±0.08)vs(0.27±0.09),P＜0.05]、左心室射血分数[(0.50±0.06)vs(0.46±0.06),P＜0.01]、最大复律能量[(96.8±65.8)J vs(156.8±100.8)J,P＜0.01]、累积转复能量[(146.8±142.6)J vs(290.5±242.1)J,P＜0.01]和电转复次数[(1.7±0.9)次vs(2.4±1.2)次,P＜0.05].多元逐步逻辑回归分析发现,房颤持续时间(β＝0.105,P＜0.01)、左心房内径(β＝0.196,P＜0.01)、左心室射血分数(β＝-20.549,P＜0.01)、转复累积能量(β＝0.004,P＜0.05)是左心耳顿抑的独立危险因素.结论房颤持续时间、左心房内径、左心室射血分数和累积复律能量是房颤电转复后左心耳顿抑的独立预测因子.     

持续性心房颤动环肺静脉消融术后随访及复发因素

目的探讨Lasso标测导管指导下环肺静脉消融术(CPVA)后心房颤动(简称房颤)早晚期复发的预测因素。方法收集持续性房颤CPVA术后患者的临床及电生理资料结合术后随访,进行多因素相关分析,了解各因素与术后房颤复发的相关性。结果共89例行CPVA术,早期复发房性心律失常29例(32.6%),其中房颤19例(21.3%),晚期共复发房颤29例(32.6%)。多因素回归分析提示最大P波时程(OR1.024,CI1.002～1.046,P=0.03)是房颤早期复发的独立预测因素;而对于房颤晚期复发来说,器质性心脏病(OR4.849,CI1.582～14.866,P=0.006)以及最大P波时程(OR1.048,CI1.017～1.080,P=0.002)是独立预测因素。结论持续性房颤CPVA术后患者,最大P波时程是早晚期复发的独立预测因素,器质性心脏病是晚期复发的独立预测因素。     

Factors predicting success rate and recurrence of atrial fibrillation after first electrical cardioversion in patients with persistent atrial fibrillation

BACKGROUND: The recurrence rate of atrial fibrillation (AF) after elective cardioversion is high. HYPOTHESIS: The study aimed to identify clinical predictors for successful electrical cardioversion and maintenance of sinus rhythm after a first electrical cardioversion in patients with persistent AF without concomitant antiarrhythmic drugs of class I and III. METHODS: Consecutive outpatients (n = 166) with persistent AF for > 1 month, scheduled for elective cardioversion, were prospectively included in the study. A clinical investigation, echocardiographic assay, and Holter electrocardiogram (ECG) before and ECG 4 weeks after cardioversion, were performed in all patients. RESULTS: The mean age of the patients was 68 years (range 45-83) and duration of AF was 5 (1-48) months. Sinus rhythm was established in 124 (75%) patients. In multivariate analysis, only duration of AF < 6 months (p < 0.04, odds ratio [OR] 2.2, 95% confidence interval [CI] 1.1 to 4.7) and patients weight (p < 0.03, OR 2.3, 95% CI 1.1 to 4.8 for weight < 80 kg) were identified as independent predictors of successful cardioversion. At 4 weeks after cardioversion, only 46 (37%) of 124 patients maintained sinus rhythm. Independent factors for maintenance of sinus rhythm, in multivariate analysis, were AF <3 months (p < 0.04, OR 2.5, 95% CI 1.1 to 5.6), treatment with beta blockers (p < 0.00001, OR 7.0, 95% CI 3.0 to 16.3) or verapamil/diltiazem (p < 0.04, OR 3.6, 95% CI 1.1 to 12.1), and right atrial dimension < 37 mm (p < 0.02, OR 5.9, 95% CI 1.4 to 25.4). CONCLUSIONS: In patients with persistent AF, the patient's weight and the duration of AF are independent predictors for a successful cardioversion. Short duration of AF, treatment with beta blockers or verapamil/diltiazem, and right atrial area/dimension are independent predictors for maintenance of sinus rhythm.     

Transoesophageal low-energy cardioversion of atrial fibrillation. Results with the oesophageal-right atrial lead configuration.

BACKGROUND: Low energy internal cardioversion is a safe and effective procedure to restore sinus rhythm in patients with atrial fibrillation refractory to external cardioversion. However the procedure is invasive and fluoroscopy is mandatory.Aim of the study To assess the efficacy, safety and tolerability of a new simplified procedure of low energy internal cardioversion. METHODS: Twenty-five consecutive patients (19 males and 6 females) with persistent atrial fibrillation were submitted to low energy internal cardioversion using a step-up protocol (in steps of 50 V, starting from 300 V). A large surface area lead (cathode) was positioned in the oesophagus, 45 cm from the nasal orifice. A second large surface area lead (anode) was positioned in the right atrium. A quadripolar lead was positioned at the right ventricular apex to achieve ventricular synchronization and back-up pacing. Oesophageal endoscopy was performed within 24 h of the end of the procedure and repeated after 48 h, if injury to the oesophageal mucosa had occurred. RESULTS: Sinus rhythm was restored in 23 patients (92%) with a mean delivered energy of 15.74 J (range 5-27) and a mean impedance of 48 Omega. In two patients, endoscopy revealed that small burns had occurred in the oesophageal mucosa. Such lesions spontaneously healed after 48 h. CONCLUSIONS: This new technique of performing low energy internal cardioversion is effective and safe and avoids the positioning of a lead in the coronary sinus or in the left pulmonary artery, thereby simplifying the procedure.     

肺静脉隔离术后心房颤动早期复发和延迟愈合的相关因素分析

目的探讨Lasso标测导管指导下行节段性肺静脉电隔离术后心房颤动(房颤)早期复发和延迟愈合的相关因素。方法120例[男性104例,女性16例;平均年龄(50．4±8．9)岁]行节段性肺静脉电隔离术的房颤患者,单因素和多因素分析老龄(≥60岁)、性别、房颤类型、病史、合并高血压、左心房直径、射血分数、P波离散度、被隔离肺静脉数及手术时间与早期复发和延迟愈合的相关性。结果早期复发率为48．3％(58／120),左心房扩大(P=0．004)和老龄(P=0．033)与早期复发显著相关,左心房直径是早期复发的独立预测因素(OR=1．16,95％CI为1．04～1．28,P=0．005);延迟愈合率为29．3％(17／58),与延迟愈合显著相关的变量为:P波离散度(P<0.001)、左心房直径(P=0．016)、老龄(P=0．001)。P波离散度是延迟愈合的独立预测因素(OR=0．92,95％CI为0．87-0．97,P=0．005)。结论左心房扩大、老龄与肺静脉隔离术后房颤早期复发有关,左心房直径是早期复发的独立预测因素;P波离散度较小、左心房无扩大的低龄患者延迟愈合的可能性较大,P波离散度是延迟愈合的独立预测因素。     

心房颤动复律前后左房结构和功能变化的超声心动图研究

目的应用超声心动图观察心房颤动(简称房颤)患者复律前后左房结构和功能的变化。方法选择房颤患者20例,按心脏复律的方式分为直流电复律组7例,药物复律组13例,分别于复律前、复律后第1天、第3天、第7天、第1个月时应用超声心动图测定左房内径和容积,记录二尖瓣血流频谱A峰流速(VA)、A峰速度时间积分(A-VTI)、心房充盈分数(AFF)和左房射血力(LAEF)。分析左房内径、容积变化与左房收缩功能的关系。应用心房肌超声组织定征技术在左房后壁心肌和心包处测量背向散射积分值(IBS)及背向散射积分周期变异幅度(CVIB)评价心肌组织的声学特征。结果房颤时所有患者均存在左房扩大,而恢复窦性心律后直流电复律组和药物复律组的左房上下径均显著降低(P<0.05或0.01)。恢复窦性心律后第1天、第3天直流电复律与药物复律组比较,左房最大和最小容积显著增大(P<0.05或0.01),VA、A-VTI、AFF和LAEF明显降低。房颤时左房心肌标化IBS较健康对照组增大,而CVIB则降低(P均<0.01),直流电复律组恢复窦性心律后第1天、第3天左房心肌标化IBS及CVIB与房颤时比较无差异(P>0.05),而药物复律组左房IBS%与房颤时和直流电复律组比较显著降低,CVIB则显著增大。恢复窦性心律后第7天、第1个月时,两组左房IBS%与房颤时比较均显著降低,CVIB显著增大(P均<0.01),两组无差异。结论两种复律方式成功复律后随时间推移均可改善房颤患者的左房结构重构和功能。     

Results of complex left atrial ablation of long-lasting persistent atrial fibrillation

PURPOSE: The aim of the study was to identify variables associated with successful long-term maintenance of sinus rhythm (SR) after a single ablation of long-lasting persistent atrial fibrillation (AF). METHODS: Complex left atrial (LA) ablation was performed in 100 patients. Restoration of SR by ablation was the desired procedure endpoint. RESULTS: SR was restored by ablation in 38 patients during the first procedure. Following one ablation, 50 patients remained in SR for 31 +/- 14 months. SR maintenance was associated with shorter duration of the persistent AF (median 14 vs. 22 months; P = 0.05), lower proportion of the LA points exhibiting voltage <0.2 mV (median 20% vs. 33%; P = 0.006), and higher proportion of LA points showing voltage >1 mV (median 15% vs. 11%; P = 0.02). CONCLUSION: Among clinical variables, shorter duration of persistent AF and higher voltage recorded around the LA predicted long-term maintenance of SR after single ablation.     

High sensitivity C-reactive protein: a predictor for recurrence of atrial fibrillation after successful cardioversion

Atrial fibrillation (AF) is often associated, more or less indirectly, with an inflammatory acute or chronic process. So it is probable that the inflammation could contribute to the genesis and the perpetuation of this dysrhythmia. Phlogistic test indexes in patients (pts) with AF will be positive and have prognostic significance in patients treated with electrical cardioversion with restoration of a sinus rhythm. We evaluated 106 pts affected by AF of recent onset without known cardiovascular disease. We measured the plasma concentration of C-reactive protein (CRP) through a high sensibility method, in addition to routine blood samples. We perfomed an ECG 1 week and a Holter ECG monitoring 1 and 6 months after the electrical cardioversion. The CRP values were high (5.8 ± 10.7 U/L), with values above the normal range in 60 pts. After electrical cardioversion, we obtained restoration of sinus rhythm in all the patients. One week after cardioversion, 85 pts (80%) were in sinus rhythm, while after 6 months 60 pts (56%) maintained a sinus rhythm. In total 46 (43%) patients had a recurrence of atrial fibrillation within 6 months, and 41 of these 46 patients (89%) had elevated values of CRP (P < 0.001 with respect to the patients who maintained a sinus rhythm). 18/21 patients (86%) with an AF relapse in the first week and 23/25 patients (92%) with AF recurrences at 6 months later had elevated values of CRP. The patients with AF may have elevated values of CRP, and the assessment of this increase may be predictive of early relapses of AF after electrical cardioversion.