Document Detail

Inefficiency of renin-angiotensin inhibitors in preventing atrial fibrillation in patients with a normal heart.
MedLine Citation:
PMID:  17534249     Owner:  NLM     Status:  MEDLINE    
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. 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. 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. 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.
G Fazio; C Pizzuto; L Sutera; D Guttilla; G Di Gesaro; C Cascio; G Novo; P Assennato; S Novo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Minerva cardioangiologica     Volume:  55     ISSN:  0026-4725     ISO Abbreviation:  Minerva Cardioangiol     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-30     Completed Date:  2007-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400725     Medline TA:  Minerva Cardioangiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  311-5     Citation Subset:  IM    
Department of Cardiology, University of Palermo, Palermo, Italy.
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MeSH Terms
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Atrial Fibrillation / drug therapy,  prevention & control*,  therapy
Drug Therapy, Combination
Electric Countershock
Follow-Up Studies
Renin-Angiotensin System / drug effects*
Retrospective Studies
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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