title: Randomized study of angiotensin II type 1 receptor blocker vs dihydropiridine calcium antagonist for the treatment of paroxysmal atrial fibrillation in patients with hypertension.
abstract: 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.
authors.affiliation: J-RHYTHM II Clinical Trial Center, The Cardiovascular Institute, Roppongi, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ogawa
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Atarashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
authors.forename: Tohru
authors.initials: T
authors.lastname: Ohe
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtsu
authors.forename: Takao
authors.initials: T
authors.lastname: Kato
authors.forename: Shiro
authors.initials: S
authors.lastname: Kamakura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kumagai
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kurachi
authors.forename: Itsuo
authors.initials: I
authors.lastname: Kodama
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Koretsune
authors.forename: Tetsunori
authors.initials: T
authors.lastname: Saikawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sakurai
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sugi
authors.forename: Haruaki
authors.initials: H
authors.lastname: Nakaya
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirai
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Fukatani
authors.forename: Hideo
authors.initials: H
authors.lastname: Mitamura
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Eiichi
authors.initials: E
authors.lastname: Watanabe
mesh_terms: 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
chemical_list: 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