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Common Genetic Polymorphism at 4q25 Locus Predicts Atrial Fibrillation Recurrence After Successful Cardioversion
Study Questions:
Is the timing of recurrent atrial fibrillation (AF) after cardioversion influenced by genetic factors?
Methods:
Sinus rhythm was restored by transthoracic cardioversion in 162/184 patients (mean age 65 years) with persistent AF who then were followed for 1 year. All patients underwent genetic analysis for four single nucleotide polymorphisms (SNPs) known to be associated with AF.
Results:
The prevalence of each of the four SNPs in the study population was 10-33%. AF recurred in 67% of patients a median of 60 days post-cardioversion. A relationship between recurrent AF and genotype was found for only one SNP (rs2200733, on chromosome 4q25, prevalence 20%). AF recurred at a median of 7 days post-cardioversion in homozygous carriers of this allele compared to a median of 54 days post-cardioversion in heterozygous carriers. By multivariate analysis, rs2200733 was an independent predictor of time to AF recurrence, with carriers having approximately a 2.5-fold higher rate of recurrent AF at 12 months.
Conclusions:
The timing of recurrent AF after transthoracic cardioversion is influenced by a commonly occurring SNP.
Perspective:
The rs2200733 SNP has been shown to be associated with a 1.7-fold higher risk of developing AF. Other studies have demonstrated that SNPs influence the risk of AF after open-heart surgery, the efficacy of antiarrhythmic drug therapy for AF, and recurrences of AF after catheter ablation. Whether genotyping will prove to be clinically useful in guiding therapy for patients with AF is an interesting issue that remains to be clarified.
Keywords: Polymorphism, Genetic
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