Angiotensin-Converting Enzyme Inhibitor Therapy Inhibits the Progression From Paroxysmal Atrial Fibrillation to Chronic Atrial Fibrillation

Yoshiyuki Hirayama; Hirotsugu Atarashi; Yoshinori Kobayashi; Tsutomu Horie; Yuuki Iwasaki; Mitsunori Maruyama; Yasushi Miyauchi; Toshihiko Ohara; Masaaki Yashima; Teruo Takano

doi:10.1253/circj.69.671

Clinical Investigation

Angiotensin-Converting Enzyme Inhibitor Therapy Inhibits the Progression From Paroxysmal Atrial Fibrillation to Chronic Atrial Fibrillation

Yoshiyuki Hirayama, Hirotsugu Atarashi, Yoshinori Kobayashi, Tsutomu Horie, Yuuki Iwasaki, Mitsunori Maruyama, Yasushi Miyauchi, Toshihiko Ohara, Masaaki Yashima, Teruo Takano

Author information

Yoshiyuki Hirayama
First Department of Internal Medicine, Nippon Medical School
Hirotsugu Atarashi
First Department of Internal Medicine, Nippon Medical School
Yoshinori Kobayashi
First Department of Internal Medicine, Nippon Medical School
Tsutomu Horie
First Department of Internal Medicine, Nippon Medical School
Yuuki Iwasaki
First Department of Internal Medicine, Nippon Medical School
Mitsunori Maruyama
First Department of Internal Medicine, Nippon Medical School
Yasushi Miyauchi
First Department of Internal Medicine, Nippon Medical School
Toshihiko Ohara
First Department of Internal Medicine, Nippon Medical School
Masaaki Yashima
First Department of Internal Medicine, Nippon Medical School
Teruo Takano
First Department of Internal Medicine, Nippon Medical School

Keywords: Angiotensin-converting enzyme inhibitors, Antiarrhythmic therapy, Paroxysmal atrial fibrillation

JOURNAL FREE ACCESS

2005 Volume 69 Issue 6 Pages 671-676

DOI https://doi.org/10.1253/circj.69.671

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Abstract

Background Atrial fibrillation is a progressive disease, which in the paroxysmal form (PAF) becomes more frequent and finally becomes chronic (CAF). A retrospective analysis of patients with PAF was conducted to examine the hypothesis that angiotensin-converting enzyme inhibitors (ACEI) will prevent the progression to CAF. Methods and Results On the basis of their treatment, 95 patients with PAF were divided into 2 groups: 42 patients treated with ACEI for hypertension throughout the period of treatment and follow-up (ACEI group) and 53 patients not given ACEI (non-ACEI group). Cardiac rhythms were assessed either from the medical records or the electrocardiograms recorded every 2-4 weeks at follow-up visits. The mean follow-up time was 8.3±3.5 years. There was no significant difference in the use of antiarrhythmic drugs, left atrial diameter or left ventricular ejection fraction between the 2 groups. The Kaplan-Meier curve for the time to occurrence of CAF showed a lower incidence of CAF in the ACEI group and demonstrated that the 5-year probability for persistence of PAF without progression to CAF was 88.3%, but 47.5% in the non-ACEI group. Conclusions These results indicate that ACEI will prevent progression from PAF to CAF. (Circ J 2005; 69: 671 - 676)

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