Visfatin as a predictor of obstructive sleep apnea in atrial fibrillation patients.

BACKGROUND: Obstructive sleep apnea (OSA) often coexists with atrial fibrillation (AF) and makes the course of AF worse. The negative impact of OSA on AF may be due to atrial stretch, hypoxia, hypertension, obesity, fibrosis, and inflammation. Several mediators are thought to be responsible for this correlation, among them adipokines such as visfatin. This study aimed to assess the association between visfatin concentrations and OSA in patients with AF. AIMS: This study aimed to assess the association between visfatin concentrations and OSA in AF patients. METHODS: In a tertiary Cardiology Department, hospitalized patients previously diagnosed with AF were enrolled in the study. Diagnosis of OSA was made based on a respiratory polygraphy and patients had blood samples taken for assessment of plasma visfatin concentration. RESULTS: A total of 266 patients with AF (65% men, age 57.6 ± 10.1) were enrolled, and 121 (45%) were diagnosed with OSA. Patients with OSA had higher visfatin concentrations than those without OSA (2.13 ± 0.17 vs. 1.70 ± 0.21 ng/mL; p = 0.04). Patients with mild OSA had visfatin levels equal to 1.77 ± 0.17 ng/mL, moderate OSA 2.38 ± 0.18 ng/mL, and severe OSA 3.55 ± 0.61 ng/mL (p for trend = 0.017). Multivariate regression analysis showed that increased visfatin concentrations were associated with the risk of OSA (odds ratio 1.92; 95% confidence interval 1.09-3.40). CONCLUSIONS: Patients with AF who were diagnosed with OSA had significantly higher plasma visfatin levels which increased according to the severity of OSA. Furthermore, multivariate regression analysis identified visfatin concentration over 1.25 ng/mL, male sex, age over 59.1 years, and permanent AF as the factors showing independent correlation with OSA.

Prevalence of obstructive sleep apnea in patients with peripheral arterial diseases.

BACKGROUND: The presence of obstructive sleep apnea (OSA), a novel cardiovascular risk factor, contributes to the development of peripheral arterial diseases (PAD). There is a lack of data showing how often these diseases coexist. AIMS: The aim of the study was to determine the prevalence of OSA in the population of patients with PAD. METHODS: Patients previously qualified for the first revascularization due to PAD were included in the study. All patients underwent an overnight sleep study to detect OSA. Diagnosis of OSA was made when the apnea-hypopnea index (AHI) was ≥5 per hour. RESULTS: From 141 patients (60% men, age 69.6 ± 9.5 years), OSA was diagnosed in 68 patients (48%). OSA occurred in mild form (5 ≤ AHI < 15/h) in 39 cases (28%), in moderate form (15 ≤ AHI < 30/h) in 21 cases (15%), and in severe form (AHI ≥ 30/h) in 8 cases (6%). Patients without OSA had significantly lower body mass index (BMI; 26.9 ± 5.5 vs. 27.7 ± 5.3 kg/m2, p = 0.01) and lower hip circumference (97.4 ± 11.7 vs. 98.7 ± 7.4, p = 0.04). There were no differences in the distribution of other investigated cardiovascular risk factors and diseases between these groups. There were no significant differences in OSA distribution or its severity between patients with lower extremity artery disease and carotid artery disease. CONCLUSIONS: The prevalence of OSA in patients with PAD is very high, affecting nearly half of the studied population.

Stratification of cardiovascular risk in patients with atrial fibrillation and obstructive sleep apnea-validity of the 2MACE score.

BACKGROUND: Risk stratification in patients with atrial fibrillation (AF) is critically important because this group is at high risk of mortality and morbidity. One of the comorbidities potentially affecting thromboembolic and total cardiovascular risk is obstructive sleep apnea (OSA). The aim of this study was to determine whether or not patients with atrial fibrillation and concomitant obstructive sleep apnea have a higher predicted cardiovascular risk than those without sleep-disordered breathing. METHODS: The study was designed to be a cross-sectional observational study. Consecutive patients with primary diagnosis of AF who qualified for first-ever catheter ablation between 2011 and 2013 were enrolled. All patients had an overnight polysomnography performed for the diagnosis of OSA and calculation of a 2MACE score-a cardiovascular risk assessment score for AF. RESULTS: We studied 211 AF patients (mean age 57.1 ± 10.2 years, 62.6% males). OSA with apnea-hypopnea index (AHI) ≥15/h was found in 48 patients (22.7%). Cardiovascular disease and risk factors were as follows: 8 (3.8%) patients had congestive heart failure, 27 (12.8%) diabetes, 16 (7.6%) history of stroke or thromboembolic disease, 194 (91.9%) arterial hypertension, 24 (11.4%) vascular disease, and 31 (14.7%) were current smokers. A significantly higher percentage of patients with OSA was at high risk of cardiovascular disease (29.2 vs. 8.1%; p < 0.0001). The trend remained significant in different categories of obstructive sleep apnea when categorized by AHI into non-OSA, and mild, moderate, and severe OSA. Similarly, the mean 2MACE score was statistically significantly higher in OSA than non-OSA patients (2.1 ± 1.1 vs. 1.4 ± 1.0; p < 0.0001). CONCLUSION: OSA prevalence is increased in AF patients and is associated with an increase 2MACE score-an indicator of major cardiovascular events. There is a linear relationship between severity of OSA and increasing 2MACE scores, indicating increasing cardiovascular risk related to OSA severity.

Prevalence of Erectile Dysfunction in Atrial Fibrillation Patients: A Cross-Sectional, Epidemiological Study.

BACKGROUND: Sexual dysfunctions, especially erectile dysfunction (ED), are a major problem in cardiovascular patients. They are caused by cardiovascular risk factors including low-grade inflammation process, endothelial dysfunction, oxidative stress, and hemodynamic and vascular alterations. The same mechanisms are some of the main causes and/or consequences of atrial fibrillation (AF). To this day, literature provides no cross-sectional data on the prevalence of sexual dysfunction in AF. The study aimed to determine the prevalence of sexual dysfunction in consecutive, young male patients with AF. MATERIAL AND METHODS: A cross-sectional survey of adult male patients with a primary diagnosis of AF was conducted at University Cardiology Departments, during the period of July 2013 to July 2014. During the enrollment process, the study participants were either electively hospitalized with a primary diagnosis of AF, or had a scheduled outpatient visit. Sexual dysfunctions were assessed using the International Index of Erectile Function. RESULTS: A total of 129 consecutive AF patients (mean age 57.0 ± 11.8 years) were analyzed. Hypertension was present in 60.5%, diabetes in 22.5% of patients, 46.5% had dyslipidemia, 18.6% were current smokers, and 45.7% had a family history of cardiovascular disease. At least one kind of sexual dysfunction was found in 86.8% of patients. ED was present in 57.4% of patients, 44.2% of patients had orgasmic dysfunction, 69.0% had lowered sexual desire, 65.1% had lowered intercourse satisfaction, and 55.8% had lowered overall satisfaction. CONCLUSIONS: Sexual dysfunctions are highly prevalent in AF patients and are not only limited to ED, but also include dysfunction of orgasmic function, desire, or general satisfaction. In part, the presence of the sexual dysfunctions is probably caused by classical cardiovascular risk factors highly prevalent in AF patients, but the impact of AF itself cannot be underestimated.

Association of the CHADS2 and CHA 2DS 2-VASc scores with left atrial enlargement: a prospective cohort study of unselected atrial fibrillation patients.

Assessment of thromboembolic risk is crucial for proper management of atrial fibrillation (AF) patients. Currently used risk score base only on scarce clinical data and do not take into consideration parameters including echocardiographic findings. The aim of this study was to evaluate if left atrium (LA) enlargement is associated with higher thromboembolic risk assessed by CHADS2 and CHA2DS2-VASc scores in a cohort of unselected non-valvular AF patients. Data from 582 AF hospitalizations occurring between November 2012 and January 2014 were analyzed. All patients underwent a standard transthoracic echocardiography and had their thromboembolic risk assessed in both CHADS2 and CHA2DS2-VASc scores. In 494 enrolled patients (48.5 % male; mean age 73.4 ± 11.5 years) AF was classified as paroxysmal in 233 (47.3 %), as persistent in 109 (22.1 %), and as permanent in 151 (30.6 %) patients. LA was enlarged in 426 (86.2 %) patients. Enlargement was classified as mild in 99 (20.0 %) patients, as moderate in 130 (26.3 %) patients, and as severe in 196 (39.7 %) patients. Patients with enlarged LA had higher mean CHADS2 score (2.0 ± 1.5 vs. 2.6 ± 1.3; p = 0.0005) and CHA2DS2-VASc (3.8 ± 2.0 vs. 4.4 ± 1.8; p = 0.02) score than patients with normal LA. The both mean scores rose along with rising LA diameter. LA enlargement is highly prevalent in AF patients. Higher thromboembolic risk assessed by both CHADS2 and CHA2DS2-VASc scores is associated with presence of LA enlargement. Echocardiographically assessed LA size may be an additional parameter useful in thromboembolic risk stratification of AF patients.

Assessment of CHADS2 and CHA 2DS 2-VASc scores in obstructive sleep apnea patients with atrial fibrillation.

PURPOSE: Assessment of stroke risk and implementation of appropriate antithrombotic therapy is an important issue in atrial fibrillation patients. Current risk scores do not take into consideration the comorbidities associated with elevated thromboembolic like obstructive sleep apnea (OSA). The aim of the study was to establish whether atrial fibrillation patients with coexisting OSA have higher stroke risk according to CHADS2 and CHA2DS2-VASc scores. METHODS: Two hundred fifty-four consecutive patients hospitalized with a primary diagnosis of atrial fibrillation participated in the study. All patients underwent whole night polygraphy and were scored in both CHADS2 and CHA2DS2-VASc according to their medical records or de novo diagnosis. RESULTS: The study population was predominantly male (65.4%; mean age, 57.5 ± 10.0 years) with a high prevalence of hypertension (73.6%), dyslipidemia (63.4%), and obesity (42.9%). OSA was present in 47.6% of patients, who more often had history of stroke (p = 0.0007). Stroke risk profile assessed by both CHADS2 and CHA2DS2-VASc scores was higher in patients with OSA (1.2 ± 0.9 vs. 0.8 ± 0.6; p < 0.0001 and 2.2 ± 1.7 vs. 1.5 ± 1.1; p = 0.001) than without it. Differences in the stroke risk remained significant across different age strata, and the trend for point values in CHADS2 and CHA2DS2-VASc scores rose along with OSA severity according to the apnea-hypopnea index (AHI; p for trend <0.001). CONCLUSIONS: OSA was highly prevalent in atrial fibrillation patients. Patients with OSA have higher CHADS2 and CHA2DS2-VASc scores. Mean CHADS2 and CHA2DS2-VASc scores rise with OSA severity. Future studies should prospectively research on potential inclusion of OSA to stroke prediction models.

Presence and severity of obstructive sleep apnea and remote outcomes of atrial fibrillation ablations - a long-term prospective, cross-sectional cohort study.

BACKGROUND: Prior studies suggested that obstructive sleep apnea (OSA) promotes recurrence of arrhythmia in patients after atrial fibrillation (AF) ablation. METHODS: In this prospective, long-term, observational study, we enrolled 290 consecutive patients admitted for AF ablation. Prior to the ablation, all patients underwent a polygraphy sleep study for the diagnosis of OSA. After the procedure, patients were followed up for mean time of 30 months for AF reoccurrence. OSA was diagnosed when apnea-hypopnea index (AHI) was ≥5. Patients were subsequently divided into groups according to the OSA severity: mild OSA (AHI 5-15/h), moderate OSA (AHI >15 and ≤30/h), and severe (AHI >30/h). RESULTS: After excluding patients disqualified from the procedure, and those with central sleep apnea, the study population consisted of 251 patients, mean age 57.6 years [163 (64.9%) male]. OSA was present in 115 (45.8%) patients, while in 137 (54.6%) cases, we observed reoccurrence of AF. Recurrence was more often in patients with, than without, OSA (65.2 vs. 45.6%; p = 0.003). We also observed that along with rising OSA severity rose also the number of patients in whom AF was detected during the follow-up period (45.6 vs. 66.2 vs. 57.6 vs. 81.8%; p = 0.005; for non-OSA, mild, moderate, and severe, respectively). CONCLUSIONS: OSA is highly prevalent in AF patients. The presence of OSA lowers chances on successful AF ablation. Early screening, and treatment for OSA in AF patients, may improve low success rates of AF ablation procedures.

Different ECG manifestations of left ventricular hypertrophy in presence of intermittent LBBB and RBBB.

An 86-year-old female with aortic stenosis was qualified for invasive correction of the valvular heart disease. She developed a severe ventricular hypertrophy (LVH) and had an intermittent left bundle branch block (LBBB) and right bundle branch block (RBBB). We report the case of a single electrocardiographic examination showing changes specific for LVH, present in all forms of intraventricular conduction. The case perfectly depicts how the intracardiac vectors of depolarization change due to bundle branch blocks and how it effects QRS complex morphology.

Occurrence of poor sleep quality in atrial fibrillation patients according to the EHRA score.

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia that affects the quality of life by causing deleterious health consequences, and impairing sleep quality. The severity of AF symptoms may range from very mild to the very intense which can be assessed by the European Heart Rhythm Association (EHRA) score. The aim of the study was to assess the prevalence of poor sleep quality in AF patients, in relation to the symptom severity based on the EHRA score. METHODS: 177 consecutive patients, hospitalized between 2011 and 2013 with non-valvular AF and no history of myocardial infarction, stroke or decompensation of heart failure within the last 6 months, were enrolled into the study. Sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI) in all patients at admission. Medical history and data concerning AF symptoms and severity by the EHRA score were gathered by a qualified physician. RESULTS: Poor sleep quality was present in 49.7% of patients. Patients with poor sleep quality were more often females (66.6% vs. 35.8%; P = 0.007), were older (57.9 +/- 10.1 vs. 53.9 +/- 10.0 years; P = 0.005), and had higher systolic blood pressures (134.4 +/- 16.4 vs. 129.8 +/- 17.8 mmHg; P = 0.03). Poor sleep quality was present in 33.3% of the EHRA I group, 43.9% of the EHRA II group, 58.1% of the EHRA III group, and 61.5% of the EHRA IV group (p value for trend 0.01). CONCLUSIONS: Poor sleep quality is highly prevalent in AF patients, affecting approximately half of them. It is related to the severity of symptoms, and prevalence rises with every degree of the EHRA score.

Long QT interval in a patient after out-of-hospital cardiac arrest with hypocalcaemia, undergoing therapeutic hypothermia.

A 53-year-old woman was hospitalized after out-of-hospital cardiac arrest due to ventricular fibrillation. Initial electrocardioagram showed sinus rhythm of 117 beats per minute, 452 ms QTc interval, ST-segment depression up to 1 mm in V(2)-V(6), and ST-elevation in lead aVR. Patient was treated with primary coronary angioplasty and therapeutic hypothermia, during which QTc interval prolonged up to 616 ms and Osborn wave was seen in lead V(4), along with elevation of ST-segment in I, II, III, aVF, V(5) and V(6); negative T waves in I, II, aVL, aVF, and V(2)-V(6). Laboratory test results showed hypocalcaemia. After rewarming and ion correction QT abnormalities resolved.

Atrial fibrillation as a first clinical manifestation of right atrial cavernous haemangioma.

Primary heart tumours are rare with an incidence of 0.02% in reported autopsy series. One of the most uncommon is haemangioma. We describe the case of a 51-year-old woman, who presented with a giant cavernous haemangioma, but with no clinical manifestations other than atrial fibrillation. Performed echocardiography showed a giant (6.5 x 7.5 cm) tumour located in the right atrium, modelling other heart chambers. In order to improve atrial haemodynamics, a large portion of the tumour was removed via sternotomy. Examination after 12 months showed no further growth of the unremoved part of the tumour.

Metabolic dysfunction-associated steatotic liver disease as a cardiovascular risk factor.

In recent years, the diagnosis and understanding of nonalcoholic fatty liver disease (NAFLD), recently redefined as metabolic dysfunction-associated steatotic liver disease (MASLD), and its relationship with cardiovascular diseases (CVD) are gaining better understanding. As MASLD shares common risk factors with CVD, including obesity, insulin resistance, hypertension, and dyslipidemia, research increasingly identifies it as a potential independent risk factor for CVD. The exact mechanisms linking MASLD to CVD remain complex and multifaceted, involving metabolic, inflammatory, and vascular pathways. Current cardiology guidelines recognize the significant association between MASLD and CVD, advocating its integration into cardiovascular risk assessment and management. Despite the progress, gaps persist in understanding underlying molecular and cellular mechanisms and the representation of diverse populations in epidemiological studies. The review illuminates the clinical implications of the MASLD-CVD link and identifies directions for future research.

Acute Myocardial Infarction Due to Antiphospholipid Syndrome - Case Report and Review of the Literature.

We present a case of acute myocardial infarction secondary to arterial thromboembolism in a 25-year-old man with systemic lupus erythematosus and antiphospholipid syndrome (APS). To our knowledge, based on the literature review, this patient is the youngest one with the acute coronary syndrome as a complication of APS. Acute myocardial infarction secondary to arterial thromboembolism is a rare presentation of APS. There are different recommended anticoagulation strategies in APS patients according to the presence of thrombosis of arterial or venous origin. Potential difficulties in the treatment may occur based on the clinical scenarios. A large number of APS patients require lifelong oral anticoagulation with vitamin K antagonists. Some non-vitamin K oral anticoagulants are being studied as drugs potentially useful in APS treatment. The recent studies suggest the role of aGAPSS score in assessing the risk of a recurrent thrombotic event as well as acute myocardial infarction in APS patients.

Prevalence of lower urinary tract symptoms in patients with cardiovascular disease.

INTRODUCTION: The presence of lower urinary tract symptoms (LUTS) might be linked with elevated cardiovascular risk. There is a lack of data showing the prevalence of LUTS in the population of patients with cardiovascular diseases. The current study aimed to determine the prevalence of LUTS in patients hospitalized due to a cardiovascular disease. MATERIAL AND METHODS: Patients hospitalized in a tertiary cardiology department due to a primary diagnosis of cardiovascular disease (including coronary artery disease, heart failure and arrhythmia) were included in the study. All patients were screened for LUTS and assessed using the International Prostate Symptoms Score (IPSS). RESULTS: From 166 patients (age 62.8 ±12.1 years), moderate to severe LUTS was diagnosed in 62 patients (37.3%). Patients with LUTS were significantly older, but there were no other factors associated with LUTS. When we divided patients according to LUTS severity, we saw an increasing prevalence of arterial hypertension (69.5% vs 72.9% vs 100%), diabetes mellitus (29.5% vs 33.3% vs 38.5%), coronary artery disease (68.6% vs 72.9% vs 92.3%), but the observations were not statistically significant. Patients with coronary artery disease had significantly higher severity of LUTS compared to patients with arrhythmia or heart failure (mean IPSS 8.88 vs 5.6 vs 5.5, p = 0.004). CONCLUSIONS: The prevalence of LUTS in patients with cardiovascular diseases is high, affecting 37.3% of the studied population. Patients with coronary artery disease have significantly higher severity of LUTS compared to other cardiovascular diseases.

Will the COVID-19 Pandemic Change National Security and Healthcare in the Spectrum of Cardiovascular Disease?

COVID-19 pandemic changed the current state of healthcare, especially in terms of reorganization of resources. Chief complaints of patients admitted to hospitals changed drastically in the proceeding months, which worsened the treatment of many acute and chronic conditions involving cardiovascular system pathologies and resources were moved in order to fight COVID-19. Moreover, the pandemic had long-term effects not only on healthcare but also national security on global scale. The COVID-19 drastically changed perception of global health and safety, trust in healthcare professionals as well as patients' willingness to seek medical help. The long-term effect of the epidemic, in terms of its impact cardiovascular disease progression and prognosis remain to be observed. The current paper discusses the impact of COVID-19 on healthcare and national security based on the currently available data.

Co-treatment of lower urinary tract symptoms and cardiovascular disease - where do we stand?

INTRODUCTION: The relationship between cardiovascular disease (CVD) and lower urinary tract symptoms (LUTS) is well established. A healthy lifestyle with a good quality diet and regular physical activity is important for reducing the severity of LUTS. MATERIAL AND METHODS: A literature search was performed on the subject of association between LUTS and cardiovascular risk. RESULTS: The recent data indicates that therapy for cardiovascular risk reduction might also reduce the severity of LUTS (e.g. statins reduce the risk of benign prostatic hyperplasia [BPH] and slow down the progression of LUTS in patients with hyperlipidaemia). Hypertensive patients treated with angiotensin II receptor blockers have a lower severity of LUTS. This paper shortly discusses the relationship between the occurrence of LUTS and CVD and the potential clinical implications regarding the management of the patients. CONCLUSIONS: Patients with lower urinary tract symptoms require a holistic approach and cooperation of a urologist and cardiologist to diagnose concomitant cardiovascular diseases as early as possible and implement appropriate treatment. Antihypertensive, antithrombotic, hypolipemic therapies and healthy lifestyles reduce not only cardiovascular mortality, but also might reduce the severity of LUTS.

History of Lyme Disease as a Predictor of Atrial Fibrillation.

In many cases, atrial fibrillation (AF) is associated with a history of cardiac inflammation. One of the potential pathogens responsible for atrial inflammation might be Borrelia burgdorferi - a pathogen involved in Lyme carditis. This study aimed to assess whether the serological history of Borrelia infection was associated with the risk of AF. The study included 113 AF patients and 109 patients in sinus rhythm. All patients underwent a clinical evaluation, echocardiography and had their blood taken for the assessment of anti-Borrelia IgG antibodies. Patients with AF compared with the non-AF group had more often serological signs of Borrelia infection (34.5% vs 6.4%; p <0.0001). The multivariate analysis showed that positive results for anti-Borrelia IgG antibodies were a strong independent predictor of AF (odds ratio 8.21; 95% confidence interval 3.08 to 21.88; p < 0.0001). In conclusion, presented data show that exposure to Borrelia spp. infection is associated with an increased risk of AF. Whether the early treatment of Lyme disease lowers the risk of AF development remains to be explored.

Usefulness of the 2MACE score as a predictor of long-term all-cause mortality in patients with atrial fibrillation.

INTRODUCTION: 2MACE is a risk assessment score designed to stratify cardiovascular risk in patients with atrial fibrillation (AF). Early detection of increased cardiovascular risk is of vital importance in this population, as it helps reduce mortality and morbidity rates. OBJECTIVES: This study aimed to assess the utility of the 2MACE score in predicting long­term mortality in patients with AF. PATIENTS AND METHODS: This was a post hoc analysis of a prospective observational cohort study including consecutive patients with nonvalvular AF, who were followed for a median duration of 81 months. RESULTS: The final analysis included 1351 patients (men, 53.1%; median [interquartile range] age, 71 [62-80] years). During the follow­up, 142 patients (10.5%) died. Deceased patients were more often classified as high risk according to the 2MACE score than survivors (80.3% vs 53.2%; P <0.0001). The receiver operator characteristic curve analysis demonstrated that the 2MACE score had a good predictive value for long­ term all cause mortality (area under the curve, 0.73; 95% CI, 0.69-0.78). The mortality rate was significantly increased in patients with a 2MACE score of 3 or higher (hazard ratio, 3.40; 95% CI, 2.33-5.49). CONCLUSIONS: The 2MACE score is a good predictor of long­ term all cause mortality in patients with AF. A progressive increase in the mortality rate was observed with an increasing 2MACE score.

Can adipokine visfatin be a novel marker of pregnancy-related disorders in women with obesity?

Overweight and obesity have become a dangerous disease requiring multiple interventions, treatment and preventions. In women of reproductive age, obesity is one of the most common medical conditions. Among others, obese state is characterized by low-grade systemic inflammation and enhanced oxidative stress. Increased maternal body mass index might amplify inflammation and reactive oxygen species production, which is associated with unfavourable clinical outcomes that affect both mother and child. Intrauterine growth retardation, preeclampsia, or gestational diabetes mellitus are examples of the hampered maternal and foetoplacental unit interactions. Visfatin is the obesity-related adipokine produced mainly by the visceral adipose tissue. Visfatin affects glucose homeostasis, as well as the regulation of genes related to oxidative stress and inflammatory response. Here, we review visfatin interactions in pregnancy-related disorders linked to obesity. We highlight the possible predictive and prognostic value of visfatin in diagnostic strategies on gravidas with obesity.

Usefulness of Visfatin as a Predictor of Atrial Fibrillation Recurrence After Ablation Procedure.

Visfatin is an adipokine produced by visceral fat tissue and takes part in fibrosis and inflammatory response. In the heart muscle, it is connected with the progression of atherosclerosis. Currently, there is no data on how visfatin affects atrial fibrillation (AF) onset. The study aimed to establish if baseline visfatin levels are connected with the risk of arrhythmia recurrence after AF ablation. In this prospective, long-term, observational study, we enrolled 290 consecutive patients admitted for AF ablation. All patients were screened for cardiovascular risk factors and had blood serum taken to measure visfatin concentrations before the ablation procedure. The end point of the study was a recurrence of the AF, defined as at least one AF episode of at any moment during the follow-up period. The screening included AF of at least 30 second duration assessed with electrocardiogram (ECG) monitoring, including 24-hour ECG Holter monitoring, implantable pacemakers, implantable defibrillators, or subcutaneous ECG monitoring devices. After excluding patients disqualified from the procedure the study population consisted of 236 patients, mean age 57.8 years (64.8% male). Mean body mass index in the population was 29.6 ± 4.8 kg/m2 and arterial hypertension was highly prevalent (73.3% of patients). In 129 (54.7%) cases we observed recurrence of AF during the follow-up period. Patients with AF recurrence had higher visfatin levels (1.7 ± 2.4 vs 2.1 ± 1.9 ng/ml; p <0.0001) and multivariate logistic regression analysis containing age, sex, and other independent variables showed that patients with elevated visfatin levels were almost 3-time more likely to experience AF recurrence (odds ratio 2.92; 95% confidence interval 1.60 to 5.32). In conclusion, patients with higher visfatin levels are at elevated risk of arrhythmia recurrence after ablation for AF. Visfatin can be a useful marker for risk stratification in this group of patients.