Valsartan for Prevention of Recurrent Atrial Fibrillation

• Published in: The New England journal of medicine Vol. 360; no. 16; pp. 1606 - 1617
• Main Authors: Disertori, Marcello, Latini, Roberto, Barlera, Simona, Franzosi, Maria Grazia, Staszewsky, Lidia, Maggioni, Aldo Pietro, Lucci, Donata, Di Pasquale, Giuseppe, Tognoni, Gianni
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 16-04-2009
• Subjects: Aged; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Atrial Fibrillation - drug therapy; Atrial Fibrillation - epidemiology; Atrial Fibrillation - prevention & control; Biological and medical sciences; Cardiac arrhythmia; Cardiomegaly - epidemiology; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Comorbidity; Diabetes Mellitus - epidemiology; Double-Blind Method; Female; General aspects; Humans; Male; Medical sciences; Middle Aged; Prevention and actions; Proportional Hazards Models; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Recurrence; Studies; Tetrazoles - therapeutic use; Valine - analogs & derivatives; Valine - therapeutic use; Valsartan; Imidazole derivatives; Tetrazole derivatives; Relapse; Arrhythmia; Valsartan; Atrial fibrillation; Peptide hormone; Cardiovascular disease; Recurrent; Excitability disorder; Medicine; Prevention; Octapeptide; Biphenyl derivatives; Aminoacid; Heart disease; Antihypertensive agent; Sartan derivatives; Angiotensin antagonist; Angiotensin II; Valine derivatives
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa0805710

In a randomized trial, 1442 patients with a history of atrial fibrillation were assigned to receive either valsartan, an angiotensin II–receptor blocker, or placebo. Antiarrhythmic therapy was administered according to the treating physician's preference. At 1 year, there was no difference between the groups in the rate of either a first recurrence or multiple recurrences of atrial fibrillation.
Patients with a history of atrial fibrillation were assigned to receive either valsartan or placebo. At 1 year, there was no difference between the groups in the rate of either a first recurrence or multiple recurrences of atrial fibrillation.
Atrial fibrillation is the most common cardiac arrhythmia.
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Antiarrhythmic drugs have only moderate efficacy in preventing recurrences of atrial fibrillation and sometimes cause serious adverse reactions.
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Ablation is a costly procedure, and accepted indications are limited.
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Thus, new approaches to the management of atrial fibrillation continue to be the subject of interest and investigation.
Some studies have shown that the recurrence of atrial fibrillation after cardioversion may be partially related to a biologic phenomenon known as remodeling, in which the electrical, mechanical, and structural properties of atrial tissue and cardiac cells are progressively and irreversibly altered, creating . . .