Atorvastatin and persistent atrial fibrillation following cardioversion: a randomized placebo-controlled multicentre study

Area of Science:

• Cardiology
• Pharmacology

Background:

• Persistent atrial fibrillation (AF) poses a significant risk for cardiovascular events.
• Electrical cardioversion (CV) is a common treatment for restoring sinus rhythm (SR) in AF patients.
• Statins are widely used for cardiovascular risk reduction, but their role in AF management post-CV is less understood.

Purpose of the Study:

• To investigate the efficacy of atorvastatin in maintaining stable sinus rhythm (SR) for 30 days following electrical cardioversion (CV) in patients with persistent atrial fibrillation (AF).

Main Methods:

• A prospective, double-blind, randomized study involving 234 patients with persistent AF.
• Patients received either atorvastatin 80 mg daily or a placebo, starting 14 days before CV and continuing for 30 days after.
• Primary endpoint was the proportion of patients in SR at 30 days post-CV.

Main Results:

• No statistically significant difference in SR maintenance at 30 days post-CV between the atorvastatin (51%) and placebo (42%) groups (P = 0.18).
• Initial conversion to SR during CV was similar in both groups (89% vs. 86%, P = 0.42).
• Atorvastatin was well-tolerated, with only one patient discontinuing due to side effects.

Conclusions:

• Atorvastatin did not demonstrate statistical superiority over placebo in maintaining SR 30 days after electrical cardioversion for persistent AF.
• The findings suggest that high-dose atorvastatin may not be beneficial for maintaining SR post-CV in this patient population.