Korean Circ J.  2009 May;39(5):185-189. 10.4070/kcj.2009.39.5.185.

Effect of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Patients Following Ablation of Atrial Fibrillation

• Park JH
• Oh YS
• Kim JH
• Chung WB
• Oh SS
• Lee DH
• Choi YS
• Shin WS
• Park CS
• Youn HJ
• Chung WS
• Lee MY
• Seung KB
• Rho TH
• Kim JH
• Hong SJ

• KMID: 1826017
• DOI: http://doi.org/10.4070/kcj.2009.39.5.185

Abstract

BACKGROUND AND OBJECTIVES: It is known that angiotensin converting enzyme inhibitors and angiotensin II type 1 receptor blockers (ACEIs and ARBs, respectively) are effective in preventing atrial fibrillation (AF) in high-risk patients. However, it is not known whether ACEIs and ARBs are effective in preventing the recurrence of AF after catheter ablation.
SUBJECTS AND METHODS
One hundred fifty-two patients (mean age, 57+/-10 years; M : F=94 : 58) who underwent catheter ablation due to drug-refractory paroxysmal (mean age, 57+/-10 years; M : F=58 : 43) or persistent AF (mean age, 56+/-10 years; M : F=36 : 15) were enrolled. We compared the recurrence rates between the groups with and without ACEIs or ARBs use in paroxysmal and persistent AF. The mean duration of follow-up was 18+/-14 months.
RESULTS
The overall recurrence rate after ablation therapy was 26% (n=39). The recurrence rate was significantly decreased in the patients with persistent AF with the use of ACEIs or ARBs (12.1% vs. 61.1%, p<0.01), but this difference was not observed in the patients with paroxysmal AF (24.2% vs. 22.9%, p=0.87). In patients with persistent AF with and without recurrence, the size of the left atrium (44.2+/-8.4 mm vs. 44.3+/-5.8 mm, respectively, p=0.45) and the ejection fraction (62+/-6.5% vs. 61.5+/-6.2%, respectively, p=0.28) were not significantly different. In multivariate analysis, the use of ACEIs or ARBs was independently associated with recurrence after adjusting for the size of the left atrium and the ejection fraction {odds ratio (OR)=0.078, 95% confidence interval (CI)=0.02-0.35, p<0.01}.
CONCLUSION
ACEIs and ARBs were shown to be effective in preventing AF recurrence after catheter ablation in patients with persistent AF.

Keyword

Atrial fibrillation; Catheter ablation; Angiotensin-converting enzyme inhibitors; Angiotensin II type 1 receptor blockers

MeSH Terms

Angiotensin II Type 1 Receptor Blockers
Angiotensin-Converting Enzyme Inhibitors
Angiotensins
Atrial Fibrillation
Catheter Ablation
Follow-Up Studies
Heart Atria
Humans
Multivariate Analysis
Peptidyl-Dipeptidase A
Recurrence
Angiotensin II Type 1 Receptor Blockers
Angiotensin-Converting Enzyme Inhibitors
Angiotensins
Peptidyl-Dipeptidase A

Figure

• 

  Fig. 1 Comparison of recurrence rates between the persistent and paroxysmal atrial fibrillation groups with and without the use of ACEIs or ARBs. A: recurrence rate in persistent AF. B: recurrence rate in paroxysmal AF. ACEIs: angiotensin converting enzyme inhibitors, ARBs: angiotensin II type 1 receptor blockers.

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