Why the study?
Does the periprocedural use of ACE inhibitors, ARBs, and diuretics prevent the development of atrial fibrillation in patients undergoing atrial flutter ablation?
Does the periprocedural use of ACE inhibitors, ARBs, and diuretics prevent the development of atrial fibrillation in patients undergoing atrial flutter ablation?
Periprocedural use of ACE inhibitors, ARBs, and diuretics is associated with a reduced risk of developing atrial fibrillation after atrial flutter ablation.
ACEI/ARB and diuretic use was associated with lower post-ablation AF; hypothesis-generating and should not yet change periprocedural practice.
OBJECTIVES: To determine risk factors for the development of atrial fibrillation (AF) after atrial flutter (AFL) ablation; and to study the relation between AF development and periprocedural drug use. METHODS: AFL ablation was performed in 196 patients. The relation between AF occurrence and clinical, echocardiographic, and procedural factors and periprocedural drug use was analysed retrospectively by a Cox proportional hazard method. RESULTS: After a median follow up of 2.2 years, 114 patients (58%) developed at least one AF episode. Factors associated with AF development were the presence of preprocedural AF, a history of cardioversion, and the number of antiarrhythmic drugs used before the procedure. Use of angiotensin converting enzyme (ACE) inhibitors/angiotensin II receptor blockers and diuretics was significantly associated by univariate and multivariate analyses with less development of AF. CONCLUSIONS: A high proportion of patients develop AF after AFL ablation. The incidence of AF is related to pre-ablation AF and its persistence. ACE inhibitors/angiotensin II receptor blockers and diuretics seem to protect against AF.
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W. Anné (2004) studied this question.
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