ABSTRACT
In this study, our aim was to evaluate the effect of a higher dose of atorvastatin on the recurrence rate of atrial fibrillation [AF] after electrical cardioversion [EC] in addition to antiarrhythmic therapy. 48 patients with persistent AF were included in this study. The patients were randomized to an atorvastatin 40-mg treatment group and a control group. Atorvastatin was started 3 weeks before EC and was continued for 2 months after EC. EC was performed using biphasic shocks after 3 weeks of treatment with the orally administered anticoagulant warfarin. Lipid and inflammatory parameters [high-sensitivity C-reactive protein, white blood cell count and fibrinogen level] were evaluated at the baseline and before EC. The endpoint of this study was electrocardiographically confirmed recurrence of AF of>10 min. There were no significant differences in baseline characteristics and lipid and inflammatory marker levels between the treatment and control groups. Total cholesterol and low-density lipoprotein levels were significantly decreased in patients taking atorvastatin for 2 months compared with baseline values [174 +/- 31 vs. 129 +/- 25 mg/dl, p=0.001, and 112 +/- 23 vs. 62 +/- 20 mg/dl, p=0.001, respectively], while no significant change occurred in control patients [168 +/- 26 vs. 182 +/- 29 mg/dl, p=0.07, and 99 +/- 18 vs. 108 +/- 26 mg/dl, p=0.1, respectively]. At the end of the 2-month follow-up period, 9 patients [20.5%] experienced AF recurrence, and there was no significant difference in AF recurrence rate between the treatment and control groups [26 vs. 13%; p=0.2]. Atorvastatin therapy prior to EC does not prevent the recurrence of arrhythmia in patients with persistent AF who are receiving antiarrhythmic therapy