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Inhibition of the Renin‐Angiotensin System for Prevention of Atrial Fibrillation
Author(s) -
ZOGRAFOS THEODOROS,
KATRITSIS DEMOSTHENES G.
Publication year - 2010
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2010.02832.x
Subject(s) - medicine , atrial fibrillation , cardiology , renin–angiotensin system , heart failure , angiotensin receptor blockers , clinical trial , cardioversion , angiotensin ii , intensive care medicine , receptor , blood pressure
Atrial fibrillation (AF) is a source of considerable morbidity and mortality. There has been compelling evidence supporting the role of renin‐angiotensin system (RAS) in the genesis and perpetuation of AF through atrial remodeling, and experimental studies have validated the utilization of RAS inhibition for AF prevention. This article reviews clinical trials on the use of angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) for the prevention of AF. Results have been variable, depending on the clinical background of treated patients. ACEIs and ARBs appear beneficial for primary prevention of AF in patients with heart failure, whereas they are not equally effective in hypertensive patients with normal left ventricular function. Furthermore, the use of ACEIs or ARBs for secondary prevention of AF has been found beneficial only after electrical cardioversion. Additional data are needed to establish the potential clinical role of renin‐angiotensin inhibition for prevention of AF. (PACE 2010; 33:1270–1285)