The Clinical Efficacy Of RAS Inhibitors Combination Therapy With Amiodarone In Patients With Persistent Non-valvular Atrial Fibrillation

Objective:To evaluate the clinical efficacy in angiotensin-converting enzyme inhibitor or angiotensin receptor inhibitor combination with amiodarone after the resumption of persistent non-valvular atrial fibrillation and the function of left atrium.Methods : sixty-seven patients with persistent non-valvular atrial fibrillation were included in the study and randomly divided into two groups: group 1(amiodarone group,n=24)was treated with amiodarone alone,group 2(amiodarone plus perindopril group,n=24) was treated with amiodarone and perindopril in combination, group 3(amiodarone plus Irbesartan group,n=23) was treated with amiodarone and irbesartan in combination.The duration of observation was up to half a year. Comparing the sinus rhythm maintenance and the left atrial diameter(LAD) in two groups before and after 3-month or 6-month treatment.Results: After 3-month treatment: There was no significant difference of LAD in the 3 groups (P>0.05). The maintenance of sinus rhythm in group 1 was lower significantly than which in group 2 or in group 3(P<0.05) .After 6-month treatment: LAD of group 1 was significantly larger than group 2 or group 3 (P<0.05),but there was no significant difference between group 2 and group 3. The maintenance of sinus rhythm in group 1 was lower significantly than which in group 2 or in group 3(P<0.05), but there was no significant difference between group 2 and group 3.Conclusion: the combination of amiodarone with perindopril or irbesartan are more effective than amiodarone alone in sinus rhythm maintenance after the resumption of persistent non-valvular atrial fibrillation ,and it can inhibit the enlargement of left atrium,but there was no significant difference between amiodarone combination with perindopril or irbesartan.