Prevention of atrial fibrillation in patients with aortic valve stenosis with candesartan treatment after aortic valve replacement.

Abstract

BACKGROUND:

Accumulating data has suggested that treatment with Angiotensin-II receptor antagonists can prevent the new onset of atrial fibrillation (AF). The aim of this study was to evaluate whether treatment with candesartan on top of conventional treatment could prevent new onset AF in patients with aortic valve stenosis (AS) after aortic valve replacement.

METHODS AND RESULTS:

The study was a single centre, consecutive; investigator initiated study using a prospective randomised blinded endpoint design. 91 patients with severe AS without known AF scheduled for aortic valve replacement (AVR) were randomised to candesartan 32 mg once daily on top of conventional treatment or conventional therapy immediately after AVR. Patients were examined with ECG 3, 6, 9 and 12 months after surgery, and Holter-ECG analysis after 3 and 12 months. Primary endpoint was episode of AF with a duration exceeding 30s, on the ECG or Holter-ECG and/or patients hospitalised due to AF. 14 patients developed new onset AF during follow up. AF-free survival was significantly higher (94% vs 74%, p=0.02) in patients treated with candesartan.

CONCLUSION:

In patients with symptomatic severe AS undergoing AVR, treatment with candesartan may prevent the new onset of atrial fibrillation.

• Authors: Jordi S Dahl, Lars Videbæk, Mikael K Poulsen, Patricia A Pellikka, Karsten Veien, Lars Ib Andersen, Torben Haghfelt, Jacob E Møller
• Journal: International journal of cardiology (Int J Cardiol) Vol. 165 Issue 2 Pg. 242-6 (May 10 2013) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 21907422 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Angiotensin II Type 1 Receptor Blockers
• Benzimidazoles
• Biphenyl Compounds
• Tetrazoles
• candesartan

Topics

• Aged
• Aged, 80 and over
• Angiotensin II Type 1 Receptor Blockers (therapeutic use)
• Aortic Valve Stenosis (diagnostic imaging, drug therapy, surgery)
• Atrial Fibrillation (diagnostic imaging, prevention & control)
• Benzimidazoles (therapeutic use)
• Biphenyl Compounds
• Female
• Follow-Up Studies
• Heart Valve Prosthesis Implantation (adverse effects)
• Humans
• Male
• Middle Aged
• Prospective Studies
• Single-Blind Method
• Tetrazoles (therapeutic use)
• Treatment Outcome
• Ultrasonography