The Effect Of Irbesartan On Hypertension With Paroxysmal Atrial Fibrillation And Left Cardiac Structure

Objective to observe the clinical effect of Irbesartan on hypertension with paroxysmal atrial fibrillation and left cardiac structure.Methods One hundred and eighty patients with hypertension and paroxysmal atrial fibrillation were enrolled,those all hadn't taken ACEI and ARB, divided randomly into two groops:treatment group(A) and control group(B). The each group had fifty-four patients. All patients bigan to take medicine in 24 hours after cardioversion, Two group of patients took amiodarone. Amiodarone was used with the first week 600 mg/d, the second week 400 mg/d, then 200 mg/d. group A added irbesartan 150 mg/d. group B added felodipine 5mg/d. Adjusting medicine dosage every two weeks,the target of blood pressure was≤130/80mmHg. The course of the treatment was 52 weeks. We measured blood pressure and adverse reaction every week. The period of taking medicine, if patiens had the similar atrial fibrillation symptom,immediately to received a medical examination nearby, makes the electrocardiogram to diagnose atrial fibrillation. We used the echocardiogram to measure the targets of the left ventricular structure before the study and 52 weeks later. The measurement data was presented as mean±standard deviation, using t test.The enumeration data was presented as percentage,using x2 test. A p value<0.05 was considered statistically significant.Results After 36 weeks treatment,there are 94 patients who have completed the whole study. Both systolic and diastolic pressure of the two groups decreased (all P<0.05).The LADd and LVMI of each group were decreased obviously compared with before in the two groops(all P<0.05), and the LADd decline of group A (48 cases) were more obvious compared with group B(46 cases) (P<0.05). Atrial fibrillation recurred in 29 cases(60.4%), and the maintenance rate of sinus rhythm was 39.6% in group A; atrial fibrillation recurred in 33 cases(73.9%), and the maintenance rate of sinus rhythm was 26.1% in group B. The recurrence rate of atrial fibrillation between the two groups was significant difference (P<0.05).Conclusion Irbesartan can reverse left ventricular hypertrophy, and improve left atrial function, and reduce recurrence rate of atrial fibrillttion.