DECREASING THE INCIDENCE OF ATRIAL FIBRILLATION (AF) IN PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION WITH ACE INHIBITORS OR ANGIOTENSIN II RECEPTOR ANTAGONISTS

摘要

Atrial fibrillation (AF) is frequently encountered in patients with heart failure (HF) and is also a predictor of morbidity and mortality in this population. Recent experimental studies have shown electrical and structural atrial remodeling with increased fibrosis in HF animals, and have suggested a preventive effect of angiotensin converting enzyme inhibitors (ACEi) on the development of AF. To verify the hypothesis that ACEi prevent the development of AF in patients with HF, a retrospective analysis of the patients from the Montreal Heart Institute (MHI) included in the Studies Of Left Ventricular Dysfunction (SOLVD) was conducted. The results of this retroactive analysis indicate that treatment with the ACE inhibitor, such as enalapril, can markedly reduce the risk of developing atrial fibrillation in patients with left ventricular dysfunction.