- 作者：Qiqi Wang ; MD* ; Yunpeng Shang ; MD* ; Zhen Wang ; MD* ; Dongchen Zhou ; MD* ; Fengqin Dong ; MD ; PHD&dagger ; ; Yuangang Qiu ; MD&Dagger ; ; Haiying Li ; MD§ ; ; Liangrong Zheng ; MD* ; gogo-home@163.com" class="auth_mail" title="E-mail the corresponding author
- 关键词：Perindopril ; Recurrence ; Atrial fibrillation ; Ablation
- 刊名：Heart Rhythm
- 出版年：2016
- 出版时间：October 2016
- 年：2016
- 卷：13
- 期：10
- 页码：2040-2047
- 全文大小：2964 K
Objective
We aimed to prove that perindopril (8 mg) could prevent recurrence after pulmonary vein isolation.
Methods
Patients with paroxysmal AF who received radiofrequency ablation were randomized to a 3-month course of perindopril 8 mg once daily (perindopril group) or placebo (placebo group). Angiotensin-II (Ang-II) therapy and standard transthoracic echocardiography were performed. All 256 patients with paroxysmal AF who received radiofrequency ablation were randomized. And we followed them for complete 1 year. The 3-month recurrence and the 1-year recurrence were compared between the 2 groups.
Results
The 3-month recurrence of AF was observed in 33 (26.19%) of 126 patients in the placebo group vs 19 (14.62%) of 130 patients who received perindopril 8 mg once daily (χ2, P = .021). One-year recurrence of AF was observed in 36 (28.5%) of 126 patients in the placebo group as compared with 21 (16.2%) of 130 patients who received perindopril after 1 year (P = .017). The κ value was 0.94 in the control group (P < .001) and 0.96 in the perindopril group (P < .001) between 3-month and 1-year recurrence. The Ang-II level was related to the left atrial distance with the reduction in AF recurrence (r = 0.17, P = .005 at 3 months; r = 0.25, P < .001 at 1 year).
Conclusion
Perindopril is an effective and safe treatment for the prevention of AF recurrence after radiofrequency catheter ablation. This effect seems to be strongly associated with a significant decrease in Ang-II level and left atrial distance.