These authors contributed equally to the manuscript.
The Effects of Statins and Renin-Angiotensin System Blockers on Atrial Fibrillation Recurrence Following Antral Pulmonary Vein Isolation
Article first published online: 25 JUN 2007
Journal of Cardiovascular Electrophysiology
Volume 18, Issue 9, pages 942–946, September 2007
How to Cite
CHEKAKIE, M. O. A., AKAR, J. G., WANG, F., MURADI, H. A., WU, J., SANTUCCI, P., VARMA, N. and WILBER, D. J. (2007), The Effects of Statins and Renin-Angiotensin System Blockers on Atrial Fibrillation Recurrence Following Antral Pulmonary Vein Isolation. Journal of Cardiovascular Electrophysiology, 18: 942–946. doi: 10.1111/j.1540-8167.2007.00887.x
Manuscript received 25 February 2007; Revised manuscript received 5 May 2007; Accepted for publication 7 May 2007.
- Issue published online: 25 JUN 2007
- Article first published online: 25 JUN 2007
- atrial fibrillation ablation;
- angiotensin converting enzyme inhibitors;
- angiotensin receptor blocker
Introduction: 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.