Key result
Renin-angiotensin system inhibitors significantly reduced the risk of atrial fibrillation recurrence after ablation compared to control (RR 0.83, 95% CI 0.70-0.98, P=0.028).
Why the study?
AF recurrence remains a tricky problem after ablation, and whether renin-angiotensin system inhibitors prevent AF recurrence after ablation required clarification.
Do renin-angiotensin system inhibitors (RASIs) prevent AF recurrence in patients undergoing ablation?
Meta-Analysis (n=4,300)
Do renin-angiotensin system inhibitors (RASIs) prevent AF recurrence in patients undergoing ablation?
Relative Risk: 0.83 (95% CI 0.7–0.98)
p-value: p=0.028
RASIs may prevent AF recurrence after ablation under selected conditions, though evidence varies by study design, region, and follow-up duration.
May support post-ablation RAS inhibitor use; hypothesis-generating and requires RCT confirmation.
BACKGROUND: Atrial fibrillation (AF) recurrence remains a tricky problem in patients undergoing ablation. This meta-analysis aimed to summarize the current literature to clarify whether renin-angiotensin system inhibitors (RASIs) prevent AF recurrence after ablation. METHODS AND RESULTS: =59.1%); negative results were found in cohort studies, studies conducted in Europe or the USA, and studies with follow-up duration <1 year. CONCLUSIONS: RASIs can potentially prevent AF recurrence after ablation under selected conditions. However, more studies are required to confirm this finding due to the variation in current evidence.
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Peng et al. (2020) conducted a meta-analysis in Atrial fibrillation undergoing ablation (n=4,300). Renin-angiotensin system inhibitors (RASIs) vs. Placebo, no treatment, or drugs other than RASIs was evaluated on Atrial fibrillation recurrence after ablation (RR 0.83, 95% CI 0.70-0.98, p=0.028). Renin-angiotensin system inhibitors significantly reduced the risk of atrial fibrillation recurrence after ablation compared to control (RR 0.83, 95% CI 0.70-0.98, P=0.028).
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