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KMID : 0368120090390050185
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Korean Circulation Journal
2009 Volume.39 No. 5 p.185 ~ p.189
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Effect of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Patients Following Ablation of Atrial Fibrillation
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Park Jeong-Hwan
Kim Jae-Hyung
Youn Ho-Joong
Chung Wook-Sung
Hong Soon-Jo
Choi Yun-Seok
Lee Dong-Hyeon
Park Chul-Soo
Lee Man-Young
Oh Su-Sung
Shin Woo-Seung
Seung Ki-Bae
Chung Woo-Baek
Kim Ji-Hoon
Oh Yong-Seog
Rho Tae-Ho
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Abstract
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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.
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KEYWORD
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Atrial fibrillation, Catheter ablation, Angiotensin-converting enzyme inhibitors, Angiotensin II type 1 receptor blockers
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