title: Prevention of atrial fibrillation in patients with aortic valve stenosis with candesartan treatment after aortic valve replacement.
abstract: BACKGROUND
  Accumulating data has suggested that treatment with Angiotensin-II receptor antagonists can prevent the new onset of atrial fibrillation (AF). The aim of this study was to evaluate whether treatment with candesartan on top of conventional treatment could prevent new onset AF in patients with aortic valve stenosis (AS) after aortic valve replacement.
  
  
  RESULTS
  The study was a single centre, consecutive; investigator initiated study using a prospective randomised blinded endpoint design. 91 patients with severe AS without known AF scheduled for aortic valve replacement (AVR) were randomised to candesartan 32 mg once daily on top of conventional treatment or conventional therapy immediately after AVR. Patients were examined with ECG 3, 6, 9 and 12 months after surgery, and Holter-ECG analysis after 3 and 12 months. Primary endpoint was episode of AF with a duration exceeding 30s, on the ECG or Holter-ECG and/or patients hospitalised due to AF. 14 patients developed new onset AF during follow up. AF-free survival was significantly higher (94% vs 74%, p=0.02) in patients treated with candesartan.
  
  
  CONCLUSIONS
  In patients with symptomatic severe AS undergoing AVR, treatment with candesartan may prevent the new onset of atrial fibrillation.
authors: Department of Cardiology, Odense University Hospital, Denmark. jordidahl@hotmail.com
authors: Jordi S
authors: JS
authors: Dahl
authors: Lars
authors: L
authors: Videbæk
authors: Mikael K
authors: MK
authors: Poulsen
authors: Patricia A
authors: PA
authors: Pellikka
authors: Karsten
authors: K
authors: Veien
authors: Lars Ib
authors: LI
authors: Andersen
authors: Torben
authors: T
authors: Haghfelt
authors: Jacob E
authors: JE
authors: Møller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000517:prevention & control*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan