| Background and Objective:Atrial fibrillation(Af) is the most commonly seen sustained arrhythmia,which occupies about one third of the patients admitted to hospital because of arrhythmias. The incidence of Af in the whole population is 0.4%-1%,and increases along with age. Although it is present in less than 0.1% of subjects under 50,it can be found in more than 1% at the age of 60 and more than 6% of older subjects( > 80 years old).There is a 2% chance of developing Af, over two decades,in patients older than 30 years according to the Framingham study.In the past 20 years,patients admitted to hospital because of Af increased by 66%. The cost of treatment for one patient per year is about $3600,which has become a great burden of the society. Though giving the best treatments, the quality of life is still bad. This makes people search new drugs. In 1990s, angiotensin II type 1 receptor blocker(ARB) came out,then was widely used to control hypertension and save target organs. So far,a series of clinical trials have shown that inhibination of RAAS can reduce the occurrence and recurrence of Af.But the effects of angiotensin II type1 receptor blocker(ARB) on cardioversion and recurrence of Af were not consistent. The main purpose of this study is to explore the influence of Candesartan on cardioversion and recurrence of Af prospectively. Methods:Ninety-nine patients with Af were given drugs or electrical cardioversion to restore sinus rhythm during Jan 2005 and Oct 2006 in the department of cardiology,the first affiliated hospital of Zhengzhou University.They were divided into 2 groups according to taking Candesartan(group B) or not(group A). In group A,there were 22 males and 12 females,aged between 41 and 87 years old,the average age was (64.0±12.7) . In group B,there were 37 males and 28 females,aged between 23 and 92 years old,the average age was (62.2±15.1) .The routine treatments were same (amiodarone/propafenone, warfarin/aspirin). Patients in group A took amiodarone 200-600mg/d or propafenone 300-450 mg/d, also they were given aspirin 75-300 mg/d or warfarin according to their risk factors.The dose of warfarin varied to keep PT-INR between 2.0 and 3.0.All patients in group B took Candesartan 4-8 mg/d one or two weeks before the routine treatments as in group A.Cardioversion rate and recent recurrence rate were observed. The measurement data was presented as mean±standard deviation,using t test. The enumeration data was presented as percentage,using X~2 test. A p value < 0.05 was considered statistically significant.Results:There were significant differences in cardioversion rate and recent recurrence rate between group A and B(P < 0.05). Group B had a higher cardioversion rate(46/65 vs 15/34,P< 0.05) and a lower recent recurrence rate(17/65 vs 18/34,P< 0.01).While,there were no significant differences in age,sex,left atrial diameter,left ventricular diameter and left ventricular ejection fraction(LVEF) between the two groups (P>0.05) .No adverse effects were seen in Group B.Conclusion:Angiotensin II type 1 receptor blocker(ARB) on basis of routine treatments can improve cardioversion rate and reduce recent recurrence rate in atrial fibrillation.
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