Perindopril For Prevention Of Atrial Fibrillation Recurrence After Radiofrequency Catheter Ablation

Object:Atrial fibrillation(AF)is associated with an increased risk of stroke and systemic embolism events.Catheter radiofrequency ablation of atrial fibrillation is one of the most important treatment options for patients with atrial fibrillation.However,the recurrence of atrial fibrillation after ablation is still common,and to some extent,affects the status of catheter ablation as a first-line therapy for atrial fibrillation.Prevention and treatment of atrial fibrillation is still a major problem in these patients with recurrent atrial fibrillation.Perindopril can inhibit the renin-angiotensin system(renin-angiotensin system RAS),improve the atrial anatomical remodeling,thereby reducing the incidence of atrial fibrillation and duration of atrial fibrillation in the patients undergoing cardioversion or cardioversion treatment,has been confirmed.In patients with atrial fibrillation who received radiofrequency ablation,the same effect was not confirmed.Our current study aims to prove that perindopril(8mg)implementation of pulmonary vein isolation in patients with atrial fibrillation can control atrial fibrillation early and late recurrence.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-?(Ang-?)therapy and standard transthoracic echocardiography were performed.All 256 patients with paroxysmal AF who received radio frequency 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(?2,P = 0.021).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(?2,P =0.017).The ? 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-? 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).Conclusions:Perindopril is an effective and safe treatment for the prevention of AF recurrence after radio frequency catheter ablation.This effect seems to be strongly associated with a significant decrease in Ang-II level and left atrial distance.The study was registered at...