Background: The kinetics of high-sensitive cardiac troponin T (hs-cTnT) levels after elective, biphasic, direct-current cardioversion for persistent atrial fibrillation/flutter remains unknown.
Methods: We examined hs-cTnT kinetics in 24 patients at baseline and at 2, 6, and 24 hours post-cardioversion, and again at 7 and 30 days. We also examined levels of creatine kinase, aspartate aminotransferase, lactate dehygrogenase, brain natriuretic peptide (BNP) and high-sensitive C-reactive protein (hs-CRP).
Results: The cardioversion procedure was successful in all of the patients, and 70% of the patients remained in sinus rhythm at 30 days following cardioversion. Mean baseline hs-cTnT concentration was 21.7±12.7 ng/L with 14 patients presenting with levels above the detection level (13 ng/L). hs-cTnT levels did not change significantly over time although they tended to decrease by 30 days (16.6±6.1 ng/L). There was no significant rise in other markers of myocardial injury. Similarly, BNP and hs-CRP levels were elevated at baseline and tended to decrease over time.
Conclusions: Patients with persistent atrial fibrillation/flutter have elevated hs-cTnT levels, as part of a general rise in biomarkers, such as BNP and hs-CRP, without a further rise after cardioversion. After cardioversion, there is a gradual, nonsignificant decrease in levels of these biomarkers over time.
