Effect of renin–angiotensin aldosteron system blockers on postoperative atrial fibrillation

Association between renin-angiotensin-aldosterone system blockers and postoperative atrial fibrillation in patients with mild and moderate left ventricular dysfunction

“…The positive results we obtained with ACEIs or ARBs are in agreement with two previous studies (13,25). In our previous study, irrespective of ejection fraction values, we have shown that ACEIs alone or combined with candesartan, an ARB decreased the incidence of postoperative AF, compared with control group (25).…”

“…In our previous study, irrespective of ejection fraction values, we have shown that ACEIs alone or combined with candesartan, an ARB decreased the incidence of postoperative AF, compared with control group (25). In the previous study (25) we did not analyze the effect of spironolactone and included all the patients, not only patients with left ventricular dysfunction. On the contrary, we in the present study included only patients with low ejection fraction and in addition to ACEIs or ARBs we evaluated spironolactone as well.…”

Atrial fibrillation and inflammation

“…ACEIs or ARBs have been shown to decrease AF in left ventricular dysfunction [64,65] and left ventricular hypertrophy [66] , and after cardiac surgery [67][68][69][70] and cardioversion [71][72][73] . In contrast, two previous studies were unable to show any beneficial effect of ACEIs and ARBs on postoperative AF [74,75] and patients in AF rhythm control strategy [76] .…”

Angiotensin converting-enzyme inhibitors and candesartan have no effects on atrial fibrillation after cardiac surgery

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We read with interest the article by Ozaydin and colleagues [1] concerning the effect of renin-angiotensin aldosteron system blockers (candesartan) on postoperative atrial fibrillation (AF).The authors describe a prospective study of 128 cardiac surgery patients and have demonstrated a significant reduced AF occurrence in angiotensin converting-enzyme inhibitors (ACEIs) and ACEIs together with candesartan groups compared to a control group (12% and 10% versus 33%, p =0.02 and p = 0.01 respectively). This has highlighted that ACEI alone and ACEI with candesartan are effective in preventing AF [1].

Although postoperative AF is often considered to be a temporary innocuous problem, this complication is associated with an increased early and late mortality [1,2,6].

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“…This has highlighted that ACEI alone and ACEI with candesartan are effective in preventing AF [1].Although postoperative AF is often considered to be a temporary innocuous problem, this complication is associated with an increased early and late mortality [1,2,6]. AF is also related to significant adverse effects such as thromboembolic complication, renal failure and hemodynamic impairment [2][3][4]7].…”