Background. Last epidemiological studies show that incidence of atrial fibrillation (AF) has increased and reached 1.9-2.9%. Electrical cardioversion (ECV) is a method of AF treatment in which an electric impulse is used to restore sinus rhythm (SR). The rate of AF recurrence after successful ECV remains pretty high and ranges from 40 to 50 % in the first month. There are evidences that elevated levels of inflammatory markers are associated with a higher risk of AF recurrence after ECV. High sensitivity C-reactive protein, C-reactive protein (CRP), interleukin-6 and tumor necrosis factor-a are common investigated inflammatory markers in the pathogenesis of cardiovascular diseases. Systemic literature analysis was performed to determine the benefit of inflammatory markers tests to predict recurrence of AF after succsesful SR restoration by ECV.
Material and methods. PMC database search have been made. This systematic review selected observational studies that were published not later than 10 years ago in which the measurements of inflammatory markers were used to predict AF recurrence after the restoration of SR by ECV.
Results. We included six prospective observational studies comprising of 536 patients in total. Follow-up time for AF recurrence lasted from 21 to 180 days. AF recurrence recorded in 43% of cases. All these studies have showed that an elevated levels of inflammatory markers have good sensitivity and specificity to predict AF recurrence. Elevated hs-CRP level was an independent predictor of AF recurrence after ECV. Elevated hs-CRP level increases likelihood ratios of AF recurrence from 1.9 to 14.5 times.
Conclusions. All these studies confirm that an elevated levels of inflammatory markers have good sensitivity and specificity to predict AF recurrence after ECV.
