PLoS ONE (Jan 2012)

Natriuretic peptides for the detection of paroxysmal atrial fibrillation in patients with cerebral ischemia--the Find-AF study.

  • Rolf Wachter,
  • Rosine Lahno,
  • Beatrice Haase,
  • Mark Weber-Krüger,
  • Joachim Seegers,
  • Frank Edelmann,
  • Janin Wohlfahrt,
  • Götz Gelbrich,
  • Anke Görlitz,
  • Pawel Kermer,
  • Dirk Vollmann,
  • Gerd Hasenfuß,
  • Klaus Gröschel,
  • Raoul Stahrenberg

DOI
https://doi.org/10.1371/journal.pone.0034351
Journal volume & issue
Vol. 7, no. 4
p. e34351

Abstract

Read online

Background and purposeDiagnosis of paroxysmal atrial fibrillation (AF) can be challenging, but it is highly relevant in patients presenting with sinus rhythm and acute cerebral ischemia. We aimed to evaluate prospectively whether natriuretic peptide levels and kinetics identify patients with paroxysmal AF.MethodsPatients with acute cerebral ischemia were included into the prospective observational Find-AF study. N-terminal pro brain-type natriuretic peptide (NT-proBNP), brain-type natriuretic peptide (BNP) and N-terminal pro atrial-type natriuretic peptide (NT-proANP) plasma levels were measured on admission, after 6 and 24 hours. Patients free from AF at presentation received 7 day Holter monitoring. We prospectively hypothesized that patients presenting in sinus rhythm with NT-proBNP>median were more likely to have paroxysmal AF than patients with NT-proBNPResults281 patients were included, of whom 237 (84.3%) presented in sinus rhythm. 220 patients naïve to AF with an evaluable prolonged Holter ECG were analysed. In patients with NT-proBNP>median (239 pg/ml), 17.9% had paroxysmal AF in contrast to 7.4% with NT-proBNPConclusionsBNP is independently predictive of paroxysmal AF detected by prolonged ECG monitoring in patients with cerebral ischemia and may be used to effectively select patients for prolonged Holter monitoring.