| The development of myocardial disease which have different etiopathogenisis to a certain degree can cause the change of heart structure,it followed with high incidence rate of arrhythm..The research of recent years indicated that atrial structural remodeling and atrial electrial remodeling have close relationship with atrial fibrillation.Dueing to the left ventricular diastolic miopragia with the patients of essential hypertension,it cause atrial morphologic change,surface area increasing,therefor it could contain more reentrant cycle.Because myofibrosis of cardiac atrium,the electric activity of cardiac atrium disparity lead to irreciprocal conductivity step down or blockage,it is the foundation of AF generate and maintenance.That is the reason of essential hypertension patients have higher AF incidence rate than health adult.Pdisp is the guide of cardiac atrium have genetic dependence unhomogen electric activity,which can identify the high risk group of essential hypertension patients who could have paroxysmal atrial fibrillation,the sensitivity and specificity of its anticipation is much higher.The research hints the activation of RAS play very important role in the atrial remodeling,so the interruption of RAS can restrain atrail remodeling,it is profit for the recover of AF and the maintain sinus rhythm,it provide theoretical basis for the prevention of AF.The patients of paroxysmal atrial fibrillation complicated with essential hypertension should use drugs which can anti-hypertension and reverse atrail remodeling,it would avoid or reduce the happen of AF.Objective:Our research through observing AF stoke status, Pdisp and left atrial diameter in the patients who are paroxysmal atrial fibrillation complicated with essential hypertension in the period of medication.To explore the clinical therapeutic effect of losartan on paroxysmal atrial fibrillation(PAF) complicated with essential hypertension(EH)Methods:In study we select 54 inpatients and out-patient clinic with EH complicated with PAF (be fit with the select and deplete standandization),they were divided randomly into treatment group and control group.Clinical data including age,gender,blood pressure,correlation case history and so on were collected.The patients in treatment group took losartan 50mg per day once daily, and took diuretics orβreceptor blockers or calcium channel blockers if necessary. The patients in control group took duretics and/orβreceptor blockers or calcium channel blockers orally. All the patients were followed up to record blood pressure and the onset of AF, when pretheraphy and in 6,12 months later, also to be checked by the echocardiogramand and. Electrocardiogram.Results:Twenty-five patients in treatment group and twenty-four patients in controlled group finished the study..In 12 month,the Pmax and Pdisp were both descended in the treatment group, To compare with pretreatment (112.79±7.6 vs127.5±6.9 37.2±10.1vs48.0±11.7), it have the statistical significance (P<0.05).To compare the onsets of AF of the two group in before and after treatment show that the onsets of AF in treatment group during 9-12 months were significantly decreased compared with pretreatment(P<0.05),the value is 5.85±1.92vs7.29±2.66;the onsets of AF in controlled group during 9-12 months were significantly increased compared with pretreament(P<0.05),the value is 7.92±1.96vs6.42±2.56;The onsets of AF in treatment group during 9-12 months were significantly decreased compared with controlled group (P<0.001).The diameter of left atrium in control group in the 12th month were larger than before treatment (37.60±5.18vs34.18±4.62) ,and the differences were significant(P<0.05).Conclusion:Losartan can degrade the Pdisp of patients who are EH complicated with PAF, and reduce the onsets of AF. Losartan maybe the latent active drug which will treat the organic myocardial disease incorporate with AF,thus it can improve the long term prognosis of patients and increase the quality of life.
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