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Candesartan in the prevention of relapsing atrial fibrillation

Arnljot Tveit1, Irene Grundvold, Mona Olufsen

  • 1Department of Internal Medicine, Asker and Baerum Hospital, 1309 Rud, Norway. arnljot.tveit@broadpark.no

International Journal of Cardiology
|November 23, 2006
PubMed

Insights

Candesartan, an angiotensin II receptor blocker, did not reduce atrial fibrillation (AF) recurrence after electrical cardioversion. This study found no significant difference in AF recurrence rates between patients treated with candesartan and those receiving a placebo.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Angiotensin converting enzyme (ACE) inhibitors and angiotensin II type 1 receptor blockers (ARBs) may reduce atrial fibrillation (AF) incidence in certain patient groups.
  • Limited data exists on the efficacy of ACE inhibitors and ARBs in patients undergoing electrical cardioversion for persistent AF.

Purpose of the Study:

  • To investigate if the ARB candesartan, without additional antiarrhythmic drugs, can lower the recurrence rate of AF after successful electrical cardioversion.
  • To test the hypothesis that candesartan treatment reduces AF recurrence post-cardioversion.

Main Methods:

  • A double-blind, placebo-controlled study involving 171 patients with persistent AF.
  • Patients were randomized to receive candesartan (8 mg daily pre-cardioversion, 16 mg daily post-cardioversion) or placebo for 3-6 weeks before and 6 months after electrical cardioversion.
  • The primary endpoint was the recurrence of AF within the 6-month follow-up period.

Main Results:

  • Successful cardioversion was achieved in 68 patients in the candesartan group and 69 in the placebo group.
  • AF recurrence was observed in 71% of the candesartan group and 65% of the placebo group within 6 months.
  • The median time to recurrence was similar in both groups (8 days for candesartan, 9 days for placebo), with no statistically significant difference.

Conclusions:

  • Treatment with candesartan before and after electrical cardioversion did not significantly affect the recurrence rate of atrial fibrillation.
  • The ARB candesartan, as used in this study, is not effective in preventing AF recurrence after electrical cardioversion.
Abstract

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