Key result
ACE inhibitors did not prevent a significant decrease in fibrillatory wave amplitude, which declined to 0.10 ± 0.02 mV in the ACE inhibitor group and 0.11 ± 0.01 mV in the non-ACE inhibitor group after 10 years.
Why the study?
Do ACE inhibitors prevent the reduction of fibrillatory wave amplitude in patients with chronic atrial fibrillation?
Observational (n=31)
No
Do ACE inhibitors prevent the reduction of fibrillatory wave amplitude in patients with chronic atrial fibrillation?
Long-term ACE inhibitor therapy does not appear to prevent the progressive reduction in fibrillatory wave amplitude, a surrogate marker for atrial fibrosis, in patients with chronic atrial fibrillation.
Answers are grounded in this paper and cite their sources.
ACE inhibitors were not associated with preserved fibrillatory wave amplitude in chronic AF; leaves open effects on atrial remodeling and should not change practice.
To examine whether angiotensin-converting enzyme (ACE) inhibitors are effective at inhibiting further fibrous changes in atria in patients with chronic atrial fibrillation, we retrospectively evaluated the time course of fibrillatory wave amplitudes and the effects of an ACE inhibitor on the changes. We reviewed medical records and electrocardiographic files. The patients were eligible for inclusion if they had chronic atrial fibrillation for more than 10 years. The fibrillatory wave with the greatest amplitude was measured in lead V1 of standard electrocardiograms. A total of 31 patients were enrolled and were divided into two groups according to treatment. Twelve patients were classified as the ACE inhibitor group and 19 as the non-ACE inhibitor group. There was no significant difference in the mean value of the fibrillatory wave amplitude at baseline between the 2 groups (ACE inhibitor group, 0.23 +/- 0.02 mV; non-ACE inhibitor group, 0.18 +/- 0.02 mV). The fibrillatory wave amplitude decreased significantly after 10 years in both groups (ACE inhibitor group, 0.10 +/- 0.02 mV; non-ACE inhibitor group, 0.11 +/- 0.01 mV) and the changes in the fibrillatory wave amplitude were similar between the 2 groups. These results suggest that ACE inhibitors are not effective at inhibiting further fibrous changes in atria in patients with chronic atrial fibrillation.
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Hirayama et al. (2004) conducted an observational in Chronic Atrial Fibrillation (n=31). Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors) vs. Non-ACE inhibitor treatment was evaluated on Change in fibrillatory wave amplitude after 10 years (p=<0.01). ACE inhibitors did not prevent a significant decrease in fibrillatory wave amplitude, which declined to 0.10 ± 0.02 mV in the ACE inhibitor group and 0.11 ± 0.01 mV in the non-ACE inhibitor group after 10 years.
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