Relationship of circulating endothelial progenitor cells to the recurrence of atrial fibrillation after successful conversion and maintenance of sinus rhythm

Europace. 2010 Apr;12(4):517-21. doi: 10.1093/europace/eup382. Epub 2009 Nov 30.


Aims: To determine whether the number of circulating endothelial progenitor cells (EPCs) in patients with persistent atrial fibrillation (AF) predicts arrhythmia recurrence after direct current cardioversion (DCCV).

Methods and results: The numbers of circulating CD34+/KDR+ EPCs were determined with flow cytometry in 51 consecutive patients with persistent AF [the mean age: 67 +/- 1.3 years, male (65%)] prior to DCCV and were compared with that of age- and sex-matched controls, and cohorts of patients with coronary artery disease and ischaemic stroke. The AF recurrence rate at 1 year was also determined. The EPCs in patients with persistent AF, patients with coronary artery disease, and patients with ischaemic stroke were significantly lower than that of the age- and sex-matched controls (P < 0.01). One year after successful DCCV, patients with high EPC count (50th to 100th percentile) had a higher recurrence rate of AF when compared with those with low EPC count (less than 50th percentile) (73 vs. 40%, P = 0.02). Cox regression analysis revealed the high EPC count was the only independent predictors for the AF recurrence (HR: 2.29, P = 0.047).

Conclusion: The number of EPCs is reduced in patients with persistent AF and predicts the recurrence of AF after successful DCCV.

MeSH terms

  • Aged
  • Atrial Fibrillation / pathology*
  • Atrial Fibrillation / therapy*
  • Biomarkers
  • Coronary Artery Disease / pathology
  • Electric Countershock*
  • Endothelial Cells / cytology*
  • Female
  • Flow Cytometry
  • Hematopoietic Stem Cells / cytology*
  • Humans
  • Male
  • Predictive Value of Tests
  • Recurrence
  • Sinoatrial Node / physiology
  • Stroke / pathology


  • Biomarkers