Can the development of atrial fibrillation in patients with ischemic heart failure with low ejection fraction be predicted?

Abstract

OBJECTIVE: Our aim is to determine the triggering factors of paroxysmal atrial fibrillation (PAF) in ischemic heart failure(HF) patients with low ejection fraction (EF).METHODS: Sixty patients were included in this study. Echocardiography and 24-hours Holter monitoring were performed after measurement of serum NT-pro BNP concentration. The patients were classified into two groups concerning the occurrenceof PAF on Holter recordings. Biochemical and echocardiographic parameters of patients with and without PAF were compared.RESULTS: PAF was detected in 28 (46%) patients. Patients with PAF demonstrated higher NT-pro BNP levels, mitral andaortic regurgitation velocities, E/A, E/E’, pulmonary capillary wedge pressure, pulmonary artery systolic pressure, left atrialvolume and volume indices. NT-pro BNP was established as the predictor of PAF (OR=1.23, 95% CI: 1.08–1.42; p=0.001).ROC analysis showed an NT-pro BNP value of 2188 pg/mL as cut-off value with 68% sensitivity and 84% specificity [Areaunder the ROC curve (AUC)=0.826, CI 95%: 0.724–0.927; p