The Efficacy Of Ras Blockers For Af Recurrence After Pulmonary Vein Isolation:a Meta-analysis And Systematic Review

Background: The activation of the renin-angiotensin system(RAS)contribute to atrial fibrillation(AF).And using RAS blockers(RAS-B)can significantly reduce the recurrence of AF.However the efficacy of RAS-B for patients after pulmonary vein isolation is uncertain..Methods: We searched the studies in PubMed,Embase and Cochrane Library to identify all the clinical studies which assessed the efficacy of RAS-B use compared with no RAS-B prescription after ablation.The outcome was the recurrence of AF after blanking period.Statistical analysis was done using Review Manager 5.3 and stata 13.Results: 12 trails with 3762 patients were included in this meta-analysis.For all the trials,the use of RAS blockers could significantly reduce the recurrence of AF after ablation procedure(OR 0.75,95% Cl 0.56-1.00,P=0.05).For cohort studies,compared with no RAS-B prescription,the use of RAS-B after abltion also could significantly reduce the rate of AF recurrence(OR 0.76,95% Cl 0.58-1.00,P=0.05).Conclusion: The use of RAS inhibitors may provide beneficial effect on the late recurrence rate of AF patient post ablation procedure.While,well designed and powered RCTs and observational studies are needed to assess this effects.