title: Angiotensin-converting enzyme inhibitor therapy inhibits the progression from paroxysmal atrial fibrillation to chronic atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation is a progressive disease, which in the paroxysmal form (PAF) becomes more frequent and finally becomes chronic (CAF). A retrospective analysis of patients with PAF was conducted to examine the hypothesis that angiotensin-converting enzyme inhibitors (ACEI) will prevent the progression to CAF.
  
  
  RESULTS
  On the basis of their treatment, 95 patients with PAF were divided into 2 groups: 42 patients treated with ACEI for hypertension throughout the period of treatment and follow-up (ACEI group) and 53 patients not given ACEI (non-ACEI group). Cardiac rhythms were assessed either from the medical records or the electrocardiograms recorded every 2-4 weeks at follow-up visits. The mean follow-up time was 8.3+/-3.5 years. There was no significant difference in the use of antiarrhythmic drugs, left atrial diameter or left ventricular ejection fraction between the 2 groups. The Kaplan-Meier curve for the time to occurrence of CAF showed a lower incidence of CAF in the ACEI group and demonstrated that the 5-year probability for persistence of PAF without progression to CAF was 88.3%, but 47.5% in the non-ACEI group.
  
  
  CONCLUSIONS
  These results indicate that ACEI will prevent progression from PAF to CAF.
authors.affiliation: First Department of Internal Medicine, Nippon Medical School, Tokyo, Japan. Hirayama@nms.ac.jp
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hirayama
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Atarashi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Horie
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Maruyama
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyauchi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ohara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yashima
authors.forename: Teruo
authors.initials: T
authors.lastname: Takano
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013614:Tachycardia, Paroxysmal / Q000150:complications / Q000188:drug therapy*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors