TURK KARDIYOLOJI DERNEGI ARSIVI, cilt.51, sa.8, ss.551-556, 2023 (ESCI)
Objective: Direct current electrical cardioversion (DCCV) is an effective rhythm-control
option for patients with atrial fibrillation (AF). Despite initial success, a high recurrence rate
remains a significant challenge. There is limited data on the genetic predictors of AF recurrence
following successful DCCV. In this study, we aimed to evaluate whether 11 single nucleotide
polymorphisms (SNPs) previously associated with AF are also linked to recurrence after DCCV
in the Turkish population.
Methods: Seventy-five patients with persistent AF, who achieved stable sinus rhythm following
DCCV, were included in the study. The patients were prospectively monitored for the onset of
AF recurrence. Clinical characteristics and SNPs were analyzed and compared between patients
who experienced recurrence and those who did not.
Results: The average age of the patients was 61.9 ± 11.5, and 33 (44%) were female. Over
an average follow-up period of 17.0 (11.0-25.0) months, AF recurrence was observed in
38 patients (50.7%). A SNP in the PITX2 gene (rs17570669) (OR: 9.00, 95% Confidence
Interval (CI): 1.28-63.02) and another in the ZFHX3 gene (rs2106261) (OR: 8.96, 95% CI:
1.03-77.66) were notably associated with AF recurrence in the additive model (P = 0.027
and 0.047, respectively). Multivariate Cox regression analysis revealed that the rs17570669
SNP was the sole independent predictor of AF recurrence (Hazard Ratio (HR): 3.59, 95% CI:
1.05-12.21, P = 0.040).
Conclusion: The SNP in the paired-like homeodomain 2 (PITX2) gene (rs17570669) emerges
as an independent predictor for AF recurrence after successful electrical cardioversion.