RT Journal Article SR Electronic T1 Natriuretic peptides for the detection of paroxysmal atrial fibrillation JF Open Heart JO Open Heart FD British Cardiovascular Society SP e000182 DO 10.1136/openhrt-2014-000182 VO 2 IS 1 A1 Seegers, Joachim A1 Zabel, Markus A1 Grüter, Timo A1 Ammermann, Antje A1 Weber-Krüger, Mark A1 Edelmann, Frank A1 Gelbrich, Götz A1 Binder, Lutz A1 Herrmann-Lingen, Christoph A1 Gröschel, Klaus A1 Hasenfuß, Gerd A1 Feltgen, Nicolas A1 Pieske, Burkert A1 Wachter, Rolf YR 2015 UL http://openheart.bmj.com/content/2/1/e000182.abstract AB Background and purpose Silent atrial fibrillation (AF) and tachycardia (AT) are considered precursors of ischaemic stroke. Therefore, detection of paroxysmal atrial rhythm disorders is highly relevant, but is clinically challenging. We aimed to evaluate the diagnostic value of natriuretic peptide levels in the detection of paroxysmal AT/AF in a pilot study.Methods Natriuretic peptide levels were analysed in two independent patient cohorts (162 patients with arterial hypertension or other cardiovascular risk factors and 82 patients with retinal vessel disease). N-terminal-pro-brain natriuretic peptide (NT-proBNP) and BNP were measured before the start of a 7-day Holter monitoring period carefully screened for AT/AF.Results 244 patients were included; 16 had paroxysmal AT/AF. After excluding patients with a history of AT/AF (n=5), 14 patients had newly diagnosed AT/AF (5.8%) NT-proBNP and BNP levels were higher in patients with paroxysmal AT/AF in both cohorts: (1) 154.4 (IQR 41.7; 303.6) versus 52.8 (30.4; 178.0) pg/mL and 70.0 (31.9; 142.4) versus 43.9 (16.3; 95.2) and (2) 216.9 (201.4; 277.1) versus 90.8 (42.3–141.7) and 96.0 (54.7; 108.2) versus 29.1 (12.0; 58.1). For the detection of AT/AF episodes, NT-proBNP and BNP had an area under the curve in receiver operating characteristic analysis of 0.76 (95% CI, 0.64 to 0.88; p=0.002) and 0.75 (0.61 to 0.89; p=0.004), respectively.Conclusions NT-proBNP and BNP levels are elevated in patients with silent AT/AF as compared with sinus rhythm. Thus, screening for undiagnosed paroxysmal AF using natriuretic peptide level initiated Holter monitoring may be a useful strategy in prevention of stroke or systemic embolism.