Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers have no beneficial effect on ablation outcome in chronic persistent atrial fibrillation

OBJECTIVE: Previous studies have shown that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) could reverse structural and electrical atria remodelling and decrease atrial fibrillation (AF) onset or recurrence. The aim of this retrospective study was to investigate whether ACEIs/ARBs had beneficial effects on ablation outcome of chronic persistent AF. METHODS AND RESULTS: This study included 139 patients with chronic persistent AF who underwent radiofrequency ablation in our centre. Patients were divided into an ACEIs/ARBs group or a non-ACEIs/ARBs group. During follow-up (14.6 +/- 8.9 months) after AF ablation, AF-free survival in the ACEIs/ARBs group was not significantly different from the non-ACEIs/ARBs group (P = 0.339). Univariate analysis showed that predictors for AF-free survival were AF history (HR, 1.064; 95% CI, 1.021-1.108; P = 0.003) and duration of chronic persistent AF (HR, 1.012; 95% CI, 1.005-1.019; P = 0.001). Multivariate analysis showed that predictors for AF-free survival were AF history (HR, 1.051; 95% CI, 1.004-1.101; P = 0.035) and duration of chronic persistent AF (HR, 1.012; 95% CI, 1.004-1.020; P = 0.004). ACEIs/ARBs therapy was not a predictor for AF-free survival neither in univariate nor multivariate analysis. CONCLUSION: In this observational study, no effect of ACEIs or ARBs was seen on the AF recurrence after ablation of chronic persistent AF.ACEIs/ARBs did not help to predict a better ablation outcome. Predictors for ablation outcome are AF history and duration of chronic persistent AF.