High Homocysteine Levels Predict the Recurrence of Atrial Fibrillation After Successful Electrical Cardioversion

Abstract

SummaryRecent data suggest that elevated plasma levels of homocysteine could be associated with atrial fibrillation (AF). The aim of our study was to investigate whether elevated plasma Hcy levels were predictive of the recurrence rate of AF after successful electrical cardioversion.Eighty-three patients (63 ± 12 years, 61.4% men) with persistent AF lasting at least 7 days were included after successful electrical cardioversion. Echocardiography and plasma homocysteine assay were performed prior to cardioversion and patient baseline characteristics were obtained. Patients were monitored for a period of 18 months.The patients were divided into two groups using a cut-off value for the last quartile of plasma homocysteine concentration (> 14.4 μmol/L). Kaplan Meier analysis showed a statistically significant difference in AF recurrence rates between both groups after 18 months (P = 0.02, log rank test). Cox proportional hazards multivariate analysis showed that predictors of AF recurrence were the duration of AF (OR 1.05, 95% CI 1.02-1.08, P = 0.00), treatment with amiodarone (OR 0.39, 95% CI 0.21-0.72, P = 0.00), and homocysteine level ≤ 14.4 μmol/L (OR 0.39, 95% CI 0.21-0.73, P = 0.00).We found that the homocysteine levels determined prior to electrical cardioversion can predict recurrence of AF after successful restoration of sinus rhythm. (Int Heart J 2010; 51: 30-33)

Plasma Concentrations and Dietary Intakes of Choline and Betaine in Association With Atrial Fibrillation Risk: Results From 3 Prospective Cohorts With Different Health Profiles

“…Regarding AF specifically, elevated plasma total homocysteine, a metabolite closely related to the choline oxidation pathway, has been associated with increased risk of AF recurrence following electrical cardioversion 33. In the Framingham Heart Study,12 no significant association between plasma betaine and risk of incident AF was reported, with age‐ and sex‐adjusted HR (95% CI) 1.03 (0.87‐1.22).…”

Biomarkers in electrophysiology: role in arrhythmias and resynchronization therapy

“…Alterations in the extracellular matrix resulting from an imbalance between MMPs and their TIMPs can lead to atrial structural remodeling, thereby creating a nidus for AF development and propagation [48]. Homocysteine, an important mediator of MMP activity, can serve as a predictor of AF recurrence [49]. In a recent prospectively conducted study [50], in patients with essential HTN and normal LVEF, those with AF had higher levels of MMP and lower levels of TIMP compared to patients with sinus rhythm.…”

Plasma homocysteine levels associated with a corrected QT interval

“…Duyuler et al found an independent relationship among the iron status, Tp-e interval and Tp-e/QT ratios of elite sport players that were also not correlated with serum homocysteine levels [33]. Previous researchers also found that the homocysteine levels determined prior to electrical cardioversion could predict recurrence of AF after successful restoration of sinus rhythms [34]. However, few studies focused on the QTc interval.…”