Angiotensin-Converting Enzyme Inhibitor Therapy Inhibits the Progression From Paroxysmal Atrial Fibrillation to Chronic Atrial Fibrillation

Hirayama, Yoshiyuki; Atarashi, Hirotsugu; Kobayashi, Yoshinori; Horie, Tsutomu; Iwasaki, Yuuki; Maruyama, Mitsunori; Miyauchi, Yasushi; Ohara, Toshihiko; Yashima, Masaaki; Takano, Teruo

doi:10.1253/circj.69.671

Cited by 39 publications

(22 citation statements)

References 25 publications

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“…154 It has been reported that, among hypertensive patients with paroxysmal AF, the incidence of chronic AF is significantly lower in those receiving than in those not receiving ACE inhibitors. 155 In a meta-analysis of large-scale clinical studies, no difference was found between ACE inhibitors and ARBs in efficacy of AF prevention. 60 Both ACE inhibitors and ARBs significantly prevented the development of new AF by 44% on average in patients with heart failure, but no significant prevention of AF by these drugs was observed in patients with hypertension.…”

Section: Upstream Treatmentmentioning

confidence: 99%

Guidelines for Pharmacotherapy of Atrial Fibrillation (JCS 2008) - Digest Version -

Group¹

2010

Circ J

123

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Section: Upstream Treatmentmentioning

confidence: 99%

Guidelines for Pharmacotherapy of Atrial Fibrillation (JCS 2008) - Digest Version -

Group¹

2010

Circ J

123

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“…26,27 Consequently, it has been believed that the prognosis of AF patients becomes worse according to the progression of AF. Actually, it has been reported that the mortality rates in patients with paroxysmal AF (0.9%) 28 was worse compared with those with persistent AF (2.6-3.7%).…”

Section: Role Of Type In Af (Paroxysmal Vs Persistent)mentioning

confidence: 99%

Prevalence and Prognosis of Patients With Atrial Fibrillation in Japan

Suzuki

Yamashita

Ohtsuka

et al. 2008

Circ J

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“…22 Based on these results, angiotensin II inhibition may help to facilitate the process of reverse AF-induced arrhythmogenic remodeling and the subsequent long-term maintenance of SR by suppressing AF relapse after the cardioversion of persistent AF. The previous clinical trials demonstrated that treatment with an ACEI or ARB had beneficial effects in AF patients with cardiac risk factors; [12][13][14][15][16][17]22,23 however, the detailed mechanism of the effect of angiotensin II blockade on AF reverse-remodeling has not been clarified. In the present study, although the elevated atrial pressure was normalized in the both groups, sustained AF was still inducible only in the non-treated control group during the recovery period of 4 weeks, but was no longer inducible in the olmesartantreated group.…”

Section: Angii Blockade and Af Reverse-remodelingmentioning

confidence: 99%

Reverse-Remodeling Effects of Angiotensin II Type 1 Receptor Blocker in a Canine Atrial Fibrillation Model

Nakashima

Kumagai

2007

Circ J

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trial fibrillation (AF) is one of the most common arrhythmias, but is still difficult to treat because of its complicated electrophysiological and pathological properties. 1 AF itself causes electrical and structural changes, which are called electrical and structural remodeling, and these changes are favorable for the maintenance of AF. [2][3][4][5][6] Previous studies have shown that structural abnormalities can induce conduction heterogeneity, which promotes local reentry and leads to the development of AF. 2,4,[6][7][8] Furthermore, some studies have demonstrated that although the electrical changes induced by AF rapidly recover after conversion to sinus rhythm (SR), the structural abnormalities persist and are vulnerable to AF induction. 4,9 We previously reported that an angiotensin II type 1 receptor blocker (ARB) can help prevent the promotion of AF by suppressing the development of an arrhythmogenic structural substrate. 10 However, the reverse-remodeling effect of ARB on existing AF-induced structural changes after the termination of AF is unclear. The purpose of this study was to investigate whether ARB therapy can help to reverse AFinduced structural remodeling and suppress AF after SR is restored in a canine atrial pacing model. Circulation Journal Vol.71, December 2007 Methods Animal Preparation and GroupsAll experiments were performed in accordance with the guidelines specified by the Institutional Animal Care and Use Committee, the American Heart Association Policy on Research Animal Use, and the Public Health Service Policy on the Use of Laboratory Animals.Ten mongrel dogs of either sex, weighing 24-26 kg, were randomly divided into 2 groups. In the olmesartan group (n=10), oral administration of olmesartan (3 mg·kg -1 ·day -1 [Sankyo Co Ltd, Tokyo, Japan]) was started after rapid atrial pacing was terminated, and was continued for a 4-week recovery period. The dogs in the control group (n=10) did not receive olmesartan.All dogs were anesthetized with an intravenous injection of pentobarbital (25 mg/kg), and, after intubation and mechanical ventilation, anesthesia was maintained with halothane. A tachy-pacing generator (Medtronic Co Ltd, Minneapolis, MN, USA) was implanted in a subcutaneous pocket in the neck and attached to a pacing lead in the right atrial appendage (RAA). The chest was opened through the right fourth intercostal space, and 4 electrode pairs were sutured to 4 sites in the right atrium (appendage, and high lateral, low lateral and anterior wall). When surgery was completed, the dogs were given antibiotics and then allowed to recover. Postoperative care included the administration of antibiotics and analgesics. Experimental ProtocolBaseline Electrophysiological Study One week after the operation, the dogs were re-anesthetized with pentobarbital (25 mg/kg) and ventilated with halothane. The arterial Circ J 2007; 71: 1977 -1982 (Received April 24, 2007 revised manuscript received July 11, 2007; accepted August 7, 2007 Reverse-Remodeling Effects of Angiotensin II Type 1 Recepto...

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Angiotensin-Converting Enzyme Inhibitor Therapy Inhibits the Progression From Paroxysmal Atrial Fibrillation to Chronic Atrial Fibrillation

Cited by 39 publications

References 25 publications

Guidelines for Pharmacotherapy of Atrial Fibrillation (JCS 2008) - Digest Version -

Guidelines for Pharmacotherapy of Atrial Fibrillation (JCS 2008) - Digest Version -

Prevalence and Prognosis of Patients With Atrial Fibrillation in Japan

Reverse-Remodeling Effects of Angiotensin II Type 1 Receptor Blocker in a Canine Atrial Fibrillation Model

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