title: [Long-term clinical efficacy of losartan or perindopril combination therapy with low-dose amiodarone in patients with paroxysmal atrial fibrillation].
abstract: OBJECTIVE
  The purpose of the present study was to evaluate the clinical efficacy of perindopril or losartan in combination with low-dose amiodarone on maintenance of sinus rhythm in patients with idiopathic paroxysmal atrial fibrillation (PAF).
  
  
  METHODS
  One hundred and eighty-one patients with idiopathic PAF were included in the study and randomly divided into three groups: group 1 (amiodarone group, n = 61) was treated with amiodarone alone, group 2 (amiodarone plus losartan, n = 59) was treated with amiodarone and perindopril in combination, and group 3 (amiodarone plus perindopril group, n = 61) was treated with amiodarone and perindopril in combination. The left atrial diameter (LAD) was measured with transthoracic echocardiogram at before and after 6, 12, 18 and 24-month of treatment. The duration of observation was up to two years and the primary end point of the study was the first recurrence of AF.
  
  
  RESULTS
  During the 6 month following up, there was no difference in LAD among the three groups. After 12 months, LAD in group 1 was significantly larger than group 2 and group 3 (P < 0.05). At 7th-month, the sinus rhythm maintenance of group 1 was lower significantly than group 2 and group 3. At the end of the study, the maintenance of sinus rhythm in group 2 and group 3 was higher significantly than in group 1 (83.05% and 80.33% vs 59.01%, P < 0.05), nevertheless, there was no significant difference between group 2 and group 3.
  
  
  CONCLUSIONS
  The results of this study suggest that the combination of amiodarone with angiotensin converting enzyme inhibitor perindopril or with angiotensin II receptor antagonist losartan are more effective than amiodarone alone in sinus rhythm maintenance for idiopathic PAF. ACEI and ARB can inhibit the enlargement of left atrium and reduce recurrence rate in patients with idiopathic PAF.
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing Cardiac Arrhythmia Therapeutic Center, Chongqing 400010, China.
authors.forename: Yue-hui
authors.initials: YH
authors.lastname: Yin
authors.forename: Zeng-chang
authors.initials: ZC
authors.lastname: Liu
authors.forename: Jin-jin
authors.initials: JJ
authors.lastname: Wu
authors.forename: Yin
authors.initials: Y
authors.lastname: Dai
authors.forename: Li
authors.initials: L
authors.lastname: Su
authors.forename: Xian-bin
authors.initials: XB
authors.lastname: Lan
authors.forename: Zhi-yu
authors.initials: ZY
authors.lastname: Ling
authors.forename: Xiao-yu
authors.initials: XY
authors.lastname: Yang
authors.forename: Kai-liang
authors.initials: KL
authors.lastname: Luo
mesh_terms: D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020913:Perindopril / Q000627:therapeutic use*; D011446:Prospective Studies
chemical_list: D000889:Anti-Arrhythmia Agents; D019808:Losartan; D000638:Amiodarone; D020913:Perindopril