A meta-analysis was undertaken to examine the relationship between plasma brain natriuretic peptide (BNP) levels and recurrence of atrial fibrillation (AF) after successful electrical cardioversion. The literature search was conducted using key inclusion criteria for papers published between January 1980 and March 2011 listed in the PubMed®/MEDLINE® database. Data were analysed using RevMan version 5.1 software; a manual search was also performed. Ten studies were finally included. Results showed that baseline BNP levels were higher in patients with AF recurrence than in those without recurrence, the standardized mean difference in plasma BNP level being −1.35 (95% confidence interval −2.17, −0.53, Z-score for overall effect 3.22). These results suggest that higher plasma BNP levels are associated with a greater risk of AF recurrence. BNP levels may predict AF recurrence after successful electrical cardioversion.
KorantzopoulosPKolettisTMGoudevenosJA: Errors and pitfalls in the non-invasive management of atrial fibrillation. Int J Cardiol2005; 104: 125–130.
2.
KuritaTMotokiKYasuokaR: Rhythm control should be better for the management of patients with atrial fibrillation and heart failure—rhythm control vs. rate control: which is better in the management of atrial fibrillation? (rhythm-side). Circ J2011; 75: 979–985.
3.
EhrlichJRNattelS: Novel approaches for pharmacological management of atrial fibrillation. Drugs2009; 69: 757–774.
4.
SahinTUralDKilicT: Right atrial appendage function in different etiologies of permanent atrial fibrillation: A transesophageal echocardiography and tissue Doppler imaging study. Echocardiography2010; 27: 384–393.
5.
SahinTUralDKilicT: Evaluation of left atrial appendage functions according to different etiologies of atrial fibrillation with a tissue Doppler imaging technique by using transesophageal echocardiography. Echocardiography2009; 26: 171–181.
6.
ThejusJFrancisJ: N-terminal pro-brain natriuretic peptide and atrial fibrillation. Indian Pacing Electrophysiol J2009; 9: 1–4.
7.
SilvetHYoung-XuYWalleighD: Brain natriuretic peptide is elevated in outpatients with atrial fibrillation. Am J Cardiol2003; 92: 1124–1127.
8.
InoueSMurakamiYSanoK: Atrium as a source of brain natriuretic polypeptide in patients with atrial fibrillation. J Card Fail2000; 6: 92–96.
9.
MabuchiNTsutamotoTMaedaK: Plasma cardiac natriuretic peptide as a biological marker of recurrence of atrial fibrillation in elderly people. Nippon Ronen Igakkai Zasshi2000; 37: 535–540 [in Japanese, English abstract].
10.
BuobAJungJSiaplaourasS: Discordant regulation of CRP and NT-proBNP plasma levels after electrical cardioversion of persistent atrial fibrillation. Pacing Clin Electrophysiol2006; 29: 559–563.
11.
Beck-da-SilvaLde BoldAFraserM: Brain natriuretic peptide predicts successful cardioversion in patients with atrial fibrillation and maintenance of sinus rhythm. Can J Cardiol2004; 20: 1245–1248.
12.
LelloucheNBerthierRDessapA Mekontso: Usefulness of plasma B-type natriuretic peptide in predicting recurrence of atrial fibrillation one year after external cardioversion. Am J Cardiol2005; 95: 1380–1382.
13.
KallergisEMManiosEGKanoupakisEM: Effect of sinus rhythm restoration after electrical cardioversion on apelin and brain natriuretic peptide prohormone levels in patients with persistent atrial fibrillation. Am J Cardiol105: 90–94.
14.
FalconeCBuzziMPAngeloA D: Apelin plasma levels predict arrhythmia recurrence in patients with persistent atrial fibrillation. Int J Immunopathol Pharmacol23: 917–925.
15.
MöllmannHWeberMElsässerA: NT-ProBNP predicts rhythm stability after cardioversion of lone atrial fibrillation. Circ J2008; 72: 921–925.
16.
TveitASeljeflotIGrundvoldI: Candesartan, NT-proBNP and recurrence of atrial fibrillation after electrical cardioversion. Int J Cardiol2009; 131: 234–239.
17.
WatanabeEArakawaTUchiyamaT: High-sensitivity C-reactive protein is predictive of successful cardioversion for atrial fibrillation and maintenance of sinus rhythm after conversion. Int J Cardiol2006; 108: 346–353.
18.
LombardiFTundoFBellettiS: C-reactive protein but not atrial dysfunction predicts recurrences of atrial fibrillation after cardioversion in patients with preserved left ventricular function. J Cardiovasc Med (Hagerstown)2008; 9: 581–588.
19.
HozoSPDjulbegovicBHozoI: Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol2005; 5: 13.
20.
HigginsJPThompsonSG: Quantifying heterogeneity in a meta-analysis. Stat Med2002; 21: 1539–1558.
21.
EggerMSmithGSchneiderM: Bias in meta-analysis detected by a simple, graphical test. BMJ1997; 315: 629–634.
22.
OgawaYItohHNakaoKL: Molecular biology and biochemistry of natriuretic peptide family. Clin Exp Pharmacol Physiol1995; 22: 49–53.
23.
TuinenburgAEBrundelBJVan GelderIC: Gene expression of the natriuretic peptide system in atrial tissue of patients with paroxysmal and persistent atrial fibrillation. J Cardiovasc Electrophysiol1999; 10: 827–835.
24.
SilvetHYoung-XuYWalleighD: Brain natriuretic peptide is elevated in outpatients with atrial fibrillation. Am J Cardiol2003; 92: 1124–1127.
25.
WatanabeMMurakamiMFurukawaH: Decreased plasma brain natriuretic peptide levels after a successful maze procedure. J Heart Valve Dis2003; 12: 287–291.
