Association of iron deficiency with atrial fibrillation recurrence after pharmacological cardioversion

Abstract

Aim. This study aims to assess the association between iron deficiency (ID) and recurrences of atrial fibrillation (AF) in patients after pharmacological cardioversion with amiodarone within 12 months.Material and methods. The open-label, prospective, single-center study included 198 patients with non-valvular paroxysmal AF after successful pharmacological cardioversion with amiodarone. Group I included 116 patients with ID, and group II — 82 patients with normal iron status. The primary end-point of the study was the development of symptomatic AF recurrences within 12 months after the cardioversion which was estimated by the Kaplan-Meier method. The differences were considered statistically significant if p-value was <0,05.Results. Absolute ID was found in patients of group I; anemia was revealed in 85,3% of the patients. The groups did not differ in basic clinical and demographical parameters, concomitant diseases and drug therapy. Along with that, the I group patients were older (the median was 73 (64,8-79) years old and 69 (63-75) years old, respectively, р=0,008), and their left ventricular mass was larger (the median was 145 (115-176) g and 132,5 (118,2-145) g, respectively, р=0,004). The sinus rhythm restoration in group I required less dose of amiodarone (the median was 450 (300-600) mg and 1000 (600-1200) mg, respectively, р<0,001) and less time from the start of the drug administration to the rhythm restoration (the median was 7 (3-10) and 12 (9-18) hours, respectively, р<0,001). During the 12-month follow-up period, 49 (42,2%) patients in group I and 16 (19,5%) patients in group II developed AF recurrences (р=0,0008), hazard ratio 2,64 (95% confidence interval: 1,5-4,65) (р=0,0003).Conclusion. ID is associated with the increase of the number of symptomatic AF recurrences in patients after pharmacological cardioversion with amiodarone within 12 months.