Abstract 17561: Efficacy of Angiotensin II Receptor Blocker on the incidence of Primary Recurrence After Ablation Treatment for Persistent Atrial Fibrillation
Introduction: While catheter ablation has come to be known as a useful therapeutic approach for paroxysmal atrial fibrillation (AF), this procedure for persistent AF is limited by a rate of AF recurrence. Previous studies have reported that angiotensin II receptor blocker (ARB) were effective to reverse structural and electrical atrial remodelling and decrease AF onset or recurrence. However, the effect of ARB for persistent AF after catheter ablation is still unclear. The aim of this single center retrospective study was to investigate the effect of ARB on the recurrence rate of AF following ablation for persistent AF.
Methods: This study included 85 patients (71males, mean age=61+/−11 years, mean AF duration=61+/−65 months) who underwent ablation for persistent AF. AF ablation consisted of circumferential pulmonary vein isolation with additional left atrial substrate modification. Patients were treated with ARB (Group-A, n=40) or without ARB (Group-B, n=45) prior to ablation and for the duration of follow-up. Recurrence of AF was defined as an episode confirmed by ECGs beyond a blanking period of 2 months after the ablation.
Results: During follow-up of 16.8+/−6.1 months after single procedure, 29 (72.5%) Group-A patients and 23 (51.1%) Group-B patients maintained sinus rhythm (SR). Treatment with ARB significantly decreased the incidence of primary recurrence rate (p=0.04, log-rank test). In multivariate analysis, treatment with ARB (HR:3.51,95% CI:1.628–7.553,P = 0.001), AF duration (HR:3.18,95% CI:1.408–7.186,P = 0.006) and left atrial dimension (HR:2.17,95% CI:1.041–4.559,P = 0.03) were independent predictor for maintenance of SR.
Conclusions: It reduces rate of recurrence of AF to give ARB to the persistent AF patients after catheter ablation.
- © 2010 by American Heart Association, Inc.