DOI: 10.1161/01.cir.0000022665.18619.83. Use of Irbesartan to Maintain Sinus Rhythm in Patients With Long-Lasting Persistent Atrial Fibrillation

Use of Irbesartan to Maintain Sinus Rhythm in Patients With Long-Lasting Persistent Atrial Fibrillation

10.1161/01.cir.0000022665.18619.83

Crossref journal-article

Ovid Technologies (Wolters Kluwer Health)

Circulation (276)

Abstract

Background — Data from studies of angiotensin-converting enzyme inhibitors provide evidence that the renin-angiotensin-aldosterone system plays a role as a mediator of atrial remodeling in atrial fibrillation. The present study has evaluated the effect of treatment with the angiotensin I type 1 receptor blocker irbesartan on maintaining sinus rhythm after conversion from persistent atrial fibrillation. Methods and Results — To be included in the present study, patients must have had an episode of persistent atrial fibrillation for >7 days. The patients were then randomized and scheduled for electrical cardioversion. Two groups of patients were compared: Group I was treated with amiodarone, and group II was treated with amiodarone plus irbesartan. The primary end point was the length of time to a first recurrence of atrial fibrillation. From a total of 186 patients assessed in the study, 154 were analyzed with the use of intention-to-treat analysis. Seventy-five patients were randomly allocated to group I and 79 to group II. After 2 months of follow-up in the intention-to-treat analysis, the group treated with irbesartan had fewer patients with recurrent atrial fibrillation (Kaplan-Meier analysis, 84.79% versus 63.16%, P =0.008). The Kaplan-Meier analysis of time to first recurrence during the follow-up period (median time, 254 days [range, 60 to 710]) also showed that patients treated with irbesartan had a greater probability of remaining free of atrial fibrillation (79.52% versus 55.91%, P =0.007). Conclusions — Patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrial fibrillation than did patients treated with amiodarone alone.

Bibliography

Madrid, A. H., Bueno, M. G., Rebollo, J. M. G., MariÌn, I., PenÌa, G., Bernal, E., Rodriguez, A., Cano, L., Cano, J. M., Cabeza, P., & Moro, C. (2002). Use of Irbesartan to Maintain Sinus Rhythm in Patients With Long-Lasting Persistent Atrial Fibrillation. Circulation, 106(3), 331â336.

Authors 11

Antonio H. Madrid (first)
Manuel G. Bueno (additional)
Jose M.G. Rebollo (additional)
Irene Marín (additional)
Gonzalo Peña (additional)
Enrique Bernal (additional)
Aníbal Rodriguez (additional)
Lucas Cano (additional)
José M. Cano (additional)
Pedro Cabeza (additional)
Concepción Moro (additional)

References 21 Referenced 517

Dates

Type	When
Created	23 years, 1 month ago (July 28, 2002, 7:16 p.m.)
Deposited	1 year, 3 months ago (May 6, 2024, 2:57 p.m.)
Indexed	3 days ago (Sept. 3, 2025, 7:11 a.m.)
Issued	23 years, 1 month ago (July 16, 2002)
Published	23 years, 1 month ago (July 16, 2002)
Published Print	23 years, 1 month ago (July 16, 2002)

Funders 0

None

BibTeX

@article{Madrid_2002, title={Use of Irbesartan to Maintain Sinus Rhythm in Patients With Long-Lasting Persistent Atrial Fibrillation: A Prospective and Randomized Study}, volume={106}, ISSN={1524-4539}, url={http://dx.doi.org/10.1161/01.cir.0000022665.18619.83}, DOI={10.1161/01.cir.0000022665.18619.83}, number={3}, journal={Circulation}, publisher={Ovid Technologies (Wolters Kluwer Health)}, author={Madrid, Antonio H. and Bueno, Manuel G. and Rebollo, Jose M.G. and Marín, Irene and Peña, Gonzalo and Bernal, Enrique and Rodriguez, Aníbal and Cano, Lucas and Cano, José M. and Cabeza, Pedro and Moro, Concepción}, year={2002}, month=jul, pages={331–336} }

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  "abstract": "<jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Background</jats:italic>\n                </jats:bold>\n                \u2014\n              </jats:italic>\n            </jats:bold>\n            Data from studies of angiotensin-converting enzyme inhibitors provide evidence that the renin-angiotensin-aldosterone system plays a role as a mediator of atrial remodeling in atrial fibrillation. The present study has evaluated the effect of treatment with the angiotensin I type 1 receptor blocker irbesartan on maintaining sinus rhythm after conversion from persistent atrial fibrillation.\n          </jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Methods and Results</jats:italic>\n                </jats:bold>\n                \u2014\n              </jats:italic>\n            </jats:bold>\n            To be included in the present study, patients must have had an episode of persistent atrial fibrillation for &gt;7 days. The patients were then randomized and scheduled for electrical cardioversion. Two groups of patients were compared: Group I was treated with amiodarone, and group II was treated with amiodarone plus irbesartan. The primary end point was the length of time to a first recurrence of atrial fibrillation. From a total of 186 patients assessed in the study, 154 were analyzed with the use of intention-to-treat analysis. Seventy-five patients were randomly allocated to group I and 79 to group II. After 2 months of follow-up in the intention-to-treat analysis, the group treated with irbesartan had fewer patients with recurrent atrial fibrillation (Kaplan-Meier analysis, 84.79% versus 63.16%,\n            <jats:italic>P</jats:italic>\n            =0.008). The Kaplan-Meier analysis of time to first recurrence during the follow-up period (median time, 254 days [range, 60 to 710]) also showed that patients treated with irbesartan had a greater probability of remaining free of atrial fibrillation (79.52% versus 55.91%,\n            <jats:italic>P</jats:italic>\n            =0.007).\n          </jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Conclusions</jats:italic>\n                </jats:bold>\n                \u2014\n              </jats:italic>\n            </jats:bold>\n            Patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrial fibrillation than did patients treated with amiodarone alone.\n          </jats:p>",
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