title: Atorvastatin prevents atrial fibrillation in patients with bradyarrhythmias and implantation of an atrial-based or dual-chamber pacemaker: a prospective randomized trial.
abstract: BACKGROUND
  Increasing evidence suggests that atrial fibrillation (AF) is an inflammatory disease. Statins is an anti-inflammatory agent. The present study was conducted to test the efficacy of atorvastatin in preventing paroxysmal AF or atrial high rate episodes (AHEs) in patients with bradyarrhythmias and implantation of an atrial-based or dual-chamber pacemaker.
  
  
  METHODS
  The effect of atorvastatin on time to the first attack of AF or AHE (> or =180 per minute and > or =1 or 10 minutes), which was accurately detected by pacemaker interrogation, was evaluated in an open-label prospective randomized design for 1 year of follow-up.
  
  
  RESULTS
  Fifty-two patients (23 males, 70 +/- 13 years old) were randomized to the statin group (atorvastatin 20 mg/d) and 54 (25 males, 72 +/- 13 years old) to the nonstatin group. Event-free survivals from AHE > or =1 minute were not significantly different between the 2 groups (log-rank P = .410). However, patients in the nonstatin group were more likely to develop AHE > or =10 minutes than those in the statin group (log-rank P = .028). Atrial high rate episode > or =10 minutes occurred in 3 (5.8%) of 51 patients in the statin group after 1 year of follow-up, and 10 (19.2%) of 52 patients (odds ratio 0.26, P = .041) in the nonstatin group. The mean left atrial volume of the statin group was significantly lower than that of the nonstatin group at the end of follow-up (39.7 +/- 1.7 vs 43.7 +/- 1.9 mL, P < .0001).
  
  
  CONCLUSIONS
  The present study demonstrated the efficacy of atorvastatin in preventing significant AF (> or =10 minutes) and left atrial enlargement in patients with bradyarrhythmias and implantation of a pacemaker.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chia-Ti
authors.initials: CT
authors.lastname: Tsai
authors.forename: Ling-Ping
authors.initials: LP
authors.lastname: Lai
authors.forename: Juey-Jen
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Yi-Chih
authors.initials: YC
authors.lastname: Wang
authors.forename: Fu-Tien
authors.initials: FT
authors.lastname: Chiang
authors.forename: Jiunn-Lee
authors.initials: JL
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000069059:Atorvastatin; D001281:Atrial Fibrillation / Q000401:mortality / Q000517:prevention & control*; D001919:Bradycardia / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010138:Pacemaker, Artificial; D011336:Probability; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage*; D012016:Reference Values; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin