Oral vitamin C administration reduces early recurrence rates after electrical cardioversion of persistent atrial fibrillation and attenuates associated inflammation (Journal article)

Korantzopoulos, P./ Kolettis, T. M./ Kountouris, E./ Dimitroula, V./ Karanikis, P./ Pappa, E./ Siogas, K./ Goudevenos, J. A.

BACKGROUND: Inflammation and oxidative stress have been recently implicated in the pathophysiology of atrial fibrillation (AF). The aim of this study was to examine the potential benefit of vitamin C on the early recurrence rates and on inflammatory indices after successful cardioversion of persistent AF, as well as to investigate the time course of changes in these indices post-cardioversion. METHODS: We prospectively studied 44 consecutive patients after successful electrical cardioversion of persistent AF. All patients received standard treatment and were randomised in one to one fashion to either oral vitamin C administration or no additional therapy. We followed-up the patients for 7 days performing successive measurements of white blood cell (WBC) count, C-reactive protein (CRP), fibrinogen, and ferritin levels. RESULTS: One week after successful cardioversion, AF recurred in 4.5% of patients in the vitamin C group and in 36.3% of patients in the control group (p=0.024). Compared to baseline values, inflammatory indices decreased after cardioversion in patients receiving vitamin C but did not change significantly in the control group. A significant variance was found in the serial measurements of WBC counts (F=5.86, p=0.001) and of fibrinogen levels (F=4.10, p=0.0084) in the two groups. In the vitamin C group CRP levels were lower on the seventh day (p<0.05). CRP and fibrinogen levels were higher in patients who relapsed into AF compared to patients who maintained sinus rhythm (F=2.77, p=0.044 and F=3.51, p=0.017, respectively). CONCLUSIONS: These findings suggest that vitamin C reduces the early recurrence rates after cardioversion of persistent AF and attenuates the associated low-level inflammation. These effects indicate that therapeutic approaches targeting at inflammation and oxidative stress may exert favourable effects on atrial electrical remodeling.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Administration, Oral,Aged,Antioxidants/*administration & dosage,Ascorbic Acid/*administration & dosage,Atrial Fibrillation/epidemiology/physiopathology/*therapy,Biological Markers/blood,C-Reactive Protein/metabolism,Echocardiography,Electric Countershock/*adverse effects,Electrocardiography/drug effects,Female,Ferritins/blood,Fibrinogen/metabolism,Follow-Up Studies,Heart Atria/ultrasonography,Humans,Incidence,Inflammation/blood/drug therapy/etiology,Leukocyte Count,Male,Myocarditis/blood/*drug therapy/etiology,Nephelometry and Turbidimetry,Oxidative Stress/physiology,Prospective Studies,Recurrence/prevention & control,Treatment Outcome
URI: https://olympias.lib.uoi.gr/jspui/handle/123456789/19586
ISSN: 0167-5273
Link: http://www.ncbi.nlm.nih.gov/pubmed/15982504
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