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The Effects of Statins and Renin‐Angiotensin System Blockers on Atrial Fibrillation Recurrence Following Antral Pulmonary Vein Isolation
Author(s) -
CHEKAKIE M. OBADAH AL,
AKAR JOSEPH G.,
WANG FEI,
MURADI HAZEM AL,
WU JOSEPH,
SANTUCCI PETER,
VARMA NIRAJ,
WILBER DAVID J
Publication year - 2007
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2007.00887.x
Subject(s) - medicine , atrial fibrillation , pulmonary vein , cardiology , ablation , renin–angiotensin system , subgroup analysis , proportional hazards model , retrospective cohort study , catheter ablation , confidence interval , blood pressure
Ablation has emerged as a major treatment option for atrial fibrillation (AF). However, this procedure is limited by a significant rate of AF recurrence. We aimed to examine the effects of statins, angiotensin‐converting enzyme inhibitors (ACE‐I), and angiotensin receptor blockers (ARB) on the recurrence rate of AF following ablation. Methods: We conducted a retrospective study of 177 consecutive patients (mean age = 56 ± 11 yrs, 69% males) who underwent ablation for paroxysmal (n = 132) or persistent AF (n = 45). Patients were treated with ACE‐I (n = 31) or ARB (n = 18) or statins (n = 50) prior to ablation and for the duration of follow‐up. Results: After a mean follow‐up of 13.8 ± 8.6 months, 72% of patients were free of AF. For patients taking statins, 33 of 50 (60%) were free of AF. In patients treated with ACE‐I, 17 of 31 (55%) were free from AF, while in the group of patients treated with ARB, 17 of 18 (94%) were free from AF. Using Cox regression analysis to correct for baseline variables, treatment with statins did not decrease the recurrence rate (HR = 1.10 [95% CI: 0.55–2.27] p = 0.79); nor did treatment with renin angiotensin system (RAS) blockers (HR 0.94 [95% CI: 0.46–1.93] p = 0.87). However, subgroup analysis showed that treatment with ARB was associated with a trend towards lower AF recurrence [HR 0.17, (95% CI: 0.02–1.34) p = 0.09]. Conclusions: Even though statins and RAS blockers possess anti‐inflammatory properties, they did not decrease the recurrence of AF following ablation. However, the subset of patients taking ARB exhibited a trend towards lower AF recurrence. Larger, randomized studies are needed to address this observation.