Impact of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the long-term outcome after pulmonary vein isolation for paroxysmal atrial fibrillation
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Impact of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the long-term outcome after pulmonary vein isolation for paroxysmal atrial fibrillation. / Klemm, Hanno U; Heitzer, Thomas; Ruprecht, Ute; Meinertz, Thomas; Ventura, Rodolfo.
in: CARDIOLOGY, Jahrgang 117, Nr. 1, 2010, S. 14-20.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Impact of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the long-term outcome after pulmonary vein isolation for paroxysmal atrial fibrillation
AU - Klemm, Hanno U
AU - Heitzer, Thomas
AU - Ruprecht, Ute
AU - Meinertz, Thomas
AU - Ventura, Rodolfo
N1 - Copyright © 2010 S. Karger AG, Basel.
PY - 2010
Y1 - 2010
N2 - OBJECTIVES: The effect of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARBs) on the long-term outcome after pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) is unknown.METHODS: This matched-pair study included 102 patients with PAF treated with ACE-I or ARBs (group 1) and 102 control subjects (group 2) after standardized PVI. Tele-ECG recorders were used to detect the end point of the first PAF recurrence after a 3-month blanking period.RESULTS: Median follow-up was 2.1 years (range 0.3-6.3). In group 1, 51 (50%) patients suffered recurrences, with a mean time to recurrence of 3.2 years (95% CI 2.6-3.8). In group 2, 67 (65.7%) patients presented PAF after a mean period of 2.2 years (95% CI 1.7-2.8; p = 0.009). A second ablation was performed in 31 (50%) patients from the treatment group and in 48 (66.7%) patients from the control group (p = 0.02). Multivariate Cox analysis showed treatment with ACE-I and ARBs to be the only significant predictor of a reduced recurrence rate (HR 0.49, 95% CI 0.32-0.75).CONCLUSION: ACE-I and ARBs were effective for the preservation of sinus rhythm after PAF ablation, and they reduced the reablation rate.
AB - OBJECTIVES: The effect of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARBs) on the long-term outcome after pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) is unknown.METHODS: This matched-pair study included 102 patients with PAF treated with ACE-I or ARBs (group 1) and 102 control subjects (group 2) after standardized PVI. Tele-ECG recorders were used to detect the end point of the first PAF recurrence after a 3-month blanking period.RESULTS: Median follow-up was 2.1 years (range 0.3-6.3). In group 1, 51 (50%) patients suffered recurrences, with a mean time to recurrence of 3.2 years (95% CI 2.6-3.8). In group 2, 67 (65.7%) patients presented PAF after a mean period of 2.2 years (95% CI 1.7-2.8; p = 0.009). A second ablation was performed in 31 (50%) patients from the treatment group and in 48 (66.7%) patients from the control group (p = 0.02). Multivariate Cox analysis showed treatment with ACE-I and ARBs to be the only significant predictor of a reduced recurrence rate (HR 0.49, 95% CI 0.32-0.75).CONCLUSION: ACE-I and ARBs were effective for the preservation of sinus rhythm after PAF ablation, and they reduced the reablation rate.
KW - Aged
KW - Angiotensin II Type 1 Receptor Blockers/therapeutic use
KW - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
KW - Atrial Fibrillation/drug therapy
KW - Catheter Ablation/methods
KW - Combined Modality Therapy
KW - Databases, Factual
KW - Electrocardiography, Ambulatory
KW - Female
KW - Follow-Up Studies
KW - Heart Conduction System/drug effects
KW - Humans
KW - Male
KW - Matched-Pair Analysis
KW - Middle Aged
KW - Proportional Hazards Models
KW - Pulmonary Veins/surgery
KW - Risk Factors
KW - Secondary Prevention
KW - Treatment Outcome
U2 - 10.1159/000318016
DO - 10.1159/000318016
M3 - SCORING: Journal article
C2 - 20881389
VL - 117
SP - 14
EP - 20
JO - CARDIOLOGY
JF - CARDIOLOGY
SN - 0008-6312
IS - 1
ER -