Brain natriuretic peptide predicts chronic atrial fibrillation after ventricular pacing in patients with sick sinus syndrome

Chronic atrial fibrillation (AF) is one of the main complications of sick s inus syndrome (SSS). As previously reported, plasma brain natriuretic pepti de (BNP), reflects hemodynamic changes in different pacing modes, as does p lasma atrial natriuretic peptide (ANP), so the present study investigated w hether plasma BNP or ANP can predict chronic AF after single-chamber ventri cular (VVI) pacemaker implantation in patients with SSS. Plasma ANP and BNP levels were measured before and 1-3 months after implantation in 99 SSS pa tients. Long-term follow-up was conducted with chronic AF as an endpoint. C hronic AF occurred in 19 patients during a mean follow-up of 5.1 years. Pla sma ANP and BNP were significantly higher in the patients who developed chr onic AF after implantation than in those who did not, despite similar ANP a nd BNP levels between the 2 groups before implantation. Post-implant high B NP and a history of paroxysmal AF were independent predictors of chronic AF by a multivariate Cox proportional hazards analysis. Plasma BNP can predic t the development of chronic AF after VVI pacemaker implantation in patient s with SSS because increased levels may reflect latent hemodynamic abnormal ities, which may contribute to the development of AF after VVI pacemaker im plantation.