title: Candesartan in the prevention of relapsing atrial fibrillation.
abstract: BACKGROUND
  Several studies have indicated that treatment with angiotensin converting enzyme (ACE) inhibitors and angiotensin II type 1 receptor blockers (ARBs) may reduce the incidence of atrial fibrillation (AF) in hypertensive patients and patients with left ventricular dysfunction. However, there is limited data on the effect of ACE-inhibitors and ARBs in patients undergoing electrical cardioversion for persistent AF. We hypothesized that treatment with the ARB candesartan, without adjunct antiarrhythmic therapy, would reduce the recurrence rate of AF after successful cardioversion.
  
  
  METHODS
  In a double blind, placebo-controlled study, 171 patients with persistent AF were randomized to receive candesartan 8 mg once daily (n=86) or placebo (n=85) for 3-6 weeks before and candesartan 16 mg once daily or placebo for 6 months after electrical cardioversion. Primary endpoint was recurrence of AF.
  
  
  RESULTS
  A total of 68 patients in the candesartan group and 69 patients in the placebo group were successfully cardioverted. Forty-eight patients (71%) in the candesartan group and 45 (65%) in the placebo group had a recurrence of AF during 6 months follow-up. Median time to recurrence was 8 and 9 days in the candesartan and placebo groups, respectively. The differences between the groups were not statistically significant.
  
  
  CONCLUSIONS
  Treatment with the ARB candesartan for 3-6 weeks before and 6 months after electrical cardioversion had no effect on the recurrence rate of AF.
authors.affiliation: Department of Internal Medicine, Asker and Baerum Hospital, 1309 Rud, Norway. arnljot.tveit@broadpark.no
authors.forename: Arnljot
authors.initials: A
authors.lastname: Tveit
authors.forename: Irene
authors.initials: I
authors.lastname: Grundvold
authors.forename: Mona
authors.initials: M
authors.lastname: Olufsen
authors.forename: Ingebjørg
authors.initials: I
authors.lastname: Seljeflot
authors.forename: Michael
authors.initials: M
authors.lastname: Abdelnoor
authors.forename: Harald
authors.initials: H
authors.lastname: Arnesen
authors.forename: Pal
authors.initials: P
authors.lastname: Smith
mesh_terms: D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000517:prevention & control*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004554:Electric Countershock; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D013777:Tetrazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan