Abstract 8236: Effect of Telmisartan on Paroxymal Atrial Fibrillation in Hypertensive Patients with Different Left Atrial Size
Aim of this study was to evaluate the effect of telmisartan (T) and amlodipine (A) on atrial fibrillation (AF) recurrence in hypertensive patients with paroxymal AF and normal or increased left atrial (LA) size. We studied 288 mild hypertensive outpatients in sinus rhythm but will at least 2 ECG-documented episodes of AF in the previous 6 months; half of them had an inferior-superior LA dimension <45 mm, and the other half >45 mm. The patients were randomized to T 80-160 mg/od (n=72 with LA <45 mm, n= 72 with LA >45 mm) or to A 5-10 mg/od (n=72 with LA <45 mm, n= 72 with LA >45 mm) for one year. Blood pressure and a 24 h ECG were evaluated monthly. Patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. SBP and DBP were significantly and similarly reduced by the 2 treatments (p<0.001 vs baseline) in the 4 groups of patients. Among those with LA dimension >45 mm a total of 35 (48.6%) patients treated with A had a recurrence of AF as did 18 (25%) patients treated with T (p<0.05 vs A) Among the patients with LA dimension <45 mm a total of 23 (31.9%) patients treated with A had a recurrence of AF as did 8 (11.1%) patients treated with T (p<0.01 vs A). Despite a similar BP lowering T was more effective than A in preventing new episodes of AF and it was particularly evident in patients with normal LA size. It suggest that in this type of patients ARB treatment is to prefer to Ca blocker treatment and that earlier it is begun greater is the prevention of AF recurrences.
- © 2011 by American Heart Association, Inc.