Randomized study of angiotensin II type 1 receptor blocker vs dihydropiridine calcium antagonist for the treatment of paroxysmal atrial fibrillation in patients with hypertension.
BACKGROUND
Mega trials of rhythm vs rate control could not demonstrate the usefulness of available antiarrhythmic drugs, so a more effective and safer therapy for atrial fibrillation (AF) is now required. One candidate is the so-called "upstream therapy", which refers to the blockade of upstream modifying elements (renin - angiotensin system, cathecholamines, oxidative stress etc) that contribute to the arrhythmogenic substrate.


RESULTS
The Japanese Rhythm Management Trial II for Atrial Fibrillation (J-RHYTHM II study) is a randomized comparative evaluation of an angiotensin II type 1 blocker (candesartan) and a dihydropiridine calcium blocker (amlodipine), both combined with antithrombotic therapy, as an antiarrhythmic therapy for the treatment of paroxysmal AF (PAF) associated with hypertension. To test the usefulness of this therapy, this study will reveal the recurrence rate of asymptomatic as well as symptomatic PAF during 1-year of treatment with candesartan or amlodipine, using daily transtelephonic monitoring.


CONCLUSIONS
The J-RHYTHM II study will follow 400 patients with PAF and hypertension who were treated at approximately 50 sites throughout Japan, and will provide clinically important information.
Yamashita
Takeshi
T
J-RHYTHM II Clinical Trial Center, The Cardiovascular Institute, Roppongi, Tokyo, Japan.
Ogawa
Satoshi
S
Aizawa
Yoshifusa
Y
Atarashi
Hirotsugu
H
Inoue
Hiroshi
H
Ohe
Tohru
T
Okumura
Ken
K
Ohtsu
Hiroshi
H
Kato
Takao
T
Kamakura
Shiro
S
Kumagai
Koichiro
K
Kurachi
Yoshihisa
Y
Kodama
Itsuo
I
Koretsune
Yukihiro
Y
Saikawa
Tetsunori
T
Sakurai
Masayuki
M
Sugi
Kaoru
K
Nakaya
Haruaki
H
Hirai
Makoto
M
Hirayama
Atsushi
A
Fukatani
Masahiko
M
Mitamura
Hideo
H
Yamazaki
Tsutomu
T
Watanabe
Eiichi
E
D017311:Amlodipine / Q000008:administration & dosage; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D001562:Benzimidazoles / Q000008:administration & dosage; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D004095:Dihydropyridines / Q000008:administration & dosage; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D055502:Secondary Prevention; D013777:Tetrazoles / Q000008:administration & dosage
D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D013777:Tetrazoles; D017311:Amlodipine; C038806:1,4-dihydropyridine; C081643:candesartan