Angiotensin-converting enzyme inhibitor therapy inhibits the progression from paroxysmal atrial fibrillation to chronic atrial fibrillation.
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.
Hirayama
Yoshiyuki
Y
First Department of Internal Medicine, Nippon Medical School, Tokyo, Japan. Hirayama@nms.ac.jp
Atarashi
Hirotsugu
H
Kobayashi
Yoshinori
Y
Horie
Tsutomu
T
Iwasaki
Yuuki
Y
Maruyama
Mitsunori
M
Miyauchi
Yasushi
Y
Ohara
Toshihiko
T
Yashima
Masaaki
M
Takano
Teruo
T
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*
D000806:Angiotensin-Converting Enzyme Inhibitors