Genetic Polymorphism On Chromosome 4q25 (Rs17570669) May Predict Recurrence After Successful Electrical Cardioversion İn Patients With Persistent Atrial Fibrillation

OBJECTIVE
Direct current electrical cardioversion (DCCV) is an effective rhythm-control option in patients with atrial fibrillation (AF). Despite initial success, a high recurrence rate is a significant problem. There is insufficient data on the genetic predictors of AF recurrence after successful DCCV. In the present study, we aimed to evaluate whether 11 single nucleotide polymorphisms (SNPs) previously shown to be associated with AF were associated with recurrence after DCCV in Turkish society.

METHODS
Seventy-five patients with persistent AF who achieved stable sinus rhythm after DCCV were included in the study. The patients were followed up prospectively for the development of AF recurrence. Clinical characteristics and SNPs were compared between those with and without recurrence.

RESULTS
The mean age of the patients was 61.9 ± 11.5, 33 of them (44%) were female. During the mean 17.0 (11.0-25.0) months follow-up, AF recurrence developed in 38 patients (50.7%). A SNP in the PITX2 gene (rs17570669) (OR: 9.00, %95 CI: 1.28-63.02) and a SNP in the ZFHX3 gene (rs2106261) (OR: 8.96, %95 CI: 1.03-77.66) were significantly associated with AF recurrence in the additive model (P=0.027 and 0.047, respectively). Multivariate Cox regression analysis showed that the rs17570669 SNP was the only independent predictor for AF recurrence (HR: 3.59, %95 CI: 1.05-12.21, P=0.040).

CONCLUSION
A SNP in the PITX2 gene (rs17570669) is the independent predictor for AF recurrence after successful electrical cardioversion.