Statins and amiodarone improve freedom from recurrence of atrial fibrillation after successful cardioversion.
BACKGROUND
Amiodarone is effective in preventing atrial fibrillation (AF). Recently, the possible antiarrhythmic effects of statins have been revealed. We hypothesized that statins added to amiodarone may reduce the recurrence rate of AF after successful electrical cardioversion (EC).


METHODS
The retrospective analysis included 198 consecutive patients (63+/-10 years; 56% men) with persistent AF (lasting at least one month, average 5.8+/-7.6 months) who underwent successful EC. All patients were put on long-time treatment with amiodarone according to standard protocol prior to EC; 50 patients (25%) also received statin therapy. AF recurrence was recorded in the following two years.


RESULTS
Recurrence of AF occurred less frequently in patients receiving statins and amiodarone than in those receiving amiodarone only (24 (48.0%) vs. 95 (64.1%) patients). The mean AF-free period was significantly prolonged in the statin-amiodarone group (513+/-38 days vs. 374+/-25 days, log rank test P<0.02). Cox univariate analysis showed that treatment with statins and the duration of AF before EC were significant predictors for AF recurrence. After adjustment for other potential confounders, statin therapy proved to be a statistically significant predictor of sinus rhythm maintenance (adjusted OR 0.60, 95% CI 0.38 to 0.93, P=0.02).


CONCLUSIONS
Our study shows that adding statins to amiodarone significantly decreases the recurrence rate of AF after successful EC in patients with persistent AF. Our findings urge for prospective randomized studies to be performed in order to confirm these results and elucidate the role of statins in AF prevention.
Naji
Franjo
F
Department of Cardiology and Angiology, University Clinical Centre, Maribor, Slovenia. franjo.naji@yahoo.com
Suran
David
D
Kanic
Vojko
V
Vokac
Damijan
D
Sabovic
Miso
M
D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000628:therapy*; D004554:Electric Countershock; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000638:Amiodarone