Almanac 2011: Cardiac arrhythmias and pacing. The national society journals present selected research that has driven recent advances in clinical cardiology

Atrial fibrillation Clinical trialsIn the past 2 years, a number of landmark clinical trials have been published which further our understanding and clinical management of patients with atrial fibrillation (AF).Two of the major goals in the treatment of this condition include reducing progression or recurrence of the arrhythmia and decreasing the risk of cardiovascular events, thereby improving quality of life and decreasing morbidity.Following on from a large body of evidence from preclinical studies, small clinical trials and meta-analysis suggesting that blockade of the renin---angiotensin system has beneficial effects on the pathophysiology of AF, 1 two large multicentre, placebo-controlled, randomised trials were conducted to determine the effects of angiotensin II receptor blockers (ARBs) on AF.The first of these trials, published in 2009, tested the hypothesis that the ARB valsartan could reduce the recurrence of AF in patients with underlying cardiovascular disease, diabetes or left atrial enlargement and a history of documented AF, in addition to established treatments.