Effect of successful electrical cardioversion on serum aldosterone in patients with persistent atrial fibrillation

Chronic elevations in systemic aldosterone levels are responsible for many adverse effects in humans, including enhanced potassium and magnesium excre tion, decreased myocardial reuptake of catecholamines, myocardial fibrosis, and baroreceptor dysfunction.(1-4) Recently, the beneficial effect of aldo sterone antagonists on myocardial performance has been clearly shown in pat ients with heart failure.(5-7) Previous studies have demonstrated that atri al fibrillation (AF) is associated with an activation of the atrial angiote nsin system.(8-10) However, the impact of AF on aldosterone levels has not been studied. Increased systemic aldosterone levels could contribute to str uctural changes of the myocardium and to fluid retention during AF. Thus, t he purpose of this prospective study was to determine whether restoration o f sinus rhythm decreases aldosterone serum levels in patients with persiste nt AF.