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Inefficiency of renin-angiotensin inhibitors in preventing atrial fibrillation in patients with a normal heart.
- Source :
-
Minerva cardioangiologica [Minerva Cardioangiol] 2007 Jun; Vol. 55 (3), pp. 311-5. - Publication Year :
- 2007
-
Abstract
- Aim: Recent scientific evidence has emphasized the possible role of inhibitors of the renin-angiotensin system in preventing arrhythmic relapses in patients with paroxysmal or persistent atrial fibrillation and co-existing left ventricular hypertrophy or left ventricular dysfunction.<br />Methods: In order to verify the effects of these drugs on patients with a normal heart, we collected a series of 187 patients admitted to our division of cardiology for paroxysmal or persistent atrial fibrillation. All patients underwent cardioversion (with antiarrhythmic drugs and/or by electrical cardioversion) and were discharged in sinus rhythm. Episodes of recurrent arrhythmia were recorded during a mean follow-up period was 2 years. Patients were subdivided into 2 groups according to therapy: group 1 comprised patients receiving renin-angiotensin system inhibitors, group 2 comprised those not receiving therapy with these agents. All 91 patients in group 1 and 76 of those in group 2 had hypertension. Among the 91 patients in the group 1, 55 were treated with angiotensin-converting enzyme (ACE) inhibitors and 36 with angiotensin receptor blockers. There were no statistically significant differences in cardiovascular risk factors or antiarrhythmic drug use between the 2 groups.<br />Results: In group 1, 83% of patients experienced <2 recurrences of atrial fibrillation during the follow-up period, while 17% had >2 episodes. In group 2, 86% of patients experienced <2 relapses during the follow-up period, while the remaining 14% had >2 relapses. There was no statistically significant difference between the 2 groups (P=0.85). A subgroup analysis showed that treatment with angiotensin receptor blockers, beta-blockers, diuretics, and calcium-channel blockers brought no advantage in sinus rhythm maintenance.<br />Conclusion: In our sample of hypertensive patients with a healthy heart, treatment with ACE inhibitors showed no statistically significant advantage in the prevention of atrial fibrillation relapses.
- Subjects :
- Aged
Angiotensin II Type 1 Receptor Blockers therapeutic use
Atrial Fibrillation drug therapy
Atrial Fibrillation therapy
Drug Therapy, Combination
Electric Countershock
Female
Follow-Up Studies
Humans
Male
Retrospective Studies
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Atrial Fibrillation prevention & control
Renin-Angiotensin System drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 0026-4725
- Volume :
- 55
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Minerva cardioangiologica
- Publication Type :
- Academic Journal
- Accession number :
- 17534249