Atorvastatin for prevention of atrial fibrillation recurrence following pulmonary vein isolation: A double-blind, placebo-controlled, randomized trial

Mahmoud Suleiman, Celeste Koestler, Amir Lerman, Francisco Lopez-Jimenez, Regina Herges, David Hodge, David John Bradley, Yong-Mei Cha, Peter A. Brady, Thomas M. Munger, Samuel J Asirvatham, Douglas L Packer, Paul Andrew Friedman

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Abstract

Background: It is known that statins are effective in preventing atrial fibrillation (AF) in patients undergoing cardiac surgery. Objective: The purpose of this study was to evaluate the efficacy of statins in preventing AF recurrence following left atrial ablation. Methods: One hundred twenty-five patients who had no statin indication undergoing catheter ablation due to drug-refractory paroxysmal (n = 90) or persistent (n = 35) AF were randomized in a prospective, double-blind, placebo-controlled trial to receive 80 mg atorvastatin (n = 62) or placebo (n = 63) for 3 months. The primary endpoint was freedom from symptomatic AF at 3 months. Secondary endpoints included freedom from any atrial arrhythmia recurrence irrespective of symptoms, quality of life (QoL), and reduction in C-reactive protein (CRP). Results: At 3 months, 95% of patients in the atorvastatin group were free of symptomatic AF compared with 93.5% in the placebo group (P =.75). Similarly, 85% of patients treated in the atorvastatin group remained free of any recurrent atrial arrhythmia vs 88% of patients in the placebo group (P =.37). Mean CRP levels decreased in the atorvastatin group (mean change -0.75 ± 3, P =.02) and increased in the placebo group (mean change 2.1 ± 19.9, P =.48). Mean QoL score improved significantly in both groups (mean change 13.14 ± 18.2 in the atorvastatin group and 11.10 ± 17.7 in the placebo group, P =.53). Conclusion: In patients with no standard indication for statin therapy, treatment with atorvastatin 80 mg/day following AF ablation does not decrease the risk of AF recurrence in the first 3 months and should not be routinely administered to prevent periprocedural arrhythmias.

Original languageEnglish (US)
Pages (from-to)172-178
Number of pages7
JournalHeart Rhythm
Volume9
Issue number2
DOIs
StatePublished - Feb 2012

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Pulmonary Veins
Atrial Fibrillation
Randomized Controlled Trials
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Placebos
Recurrence
Cardiac Arrhythmias
C-Reactive Protein
Quality of Life
Catheter Ablation
Atorvastatin Calcium
Thoracic Surgery
Therapeutics
Pharmaceutical Preparations

Keywords

  • Atorvastatin
  • Atrial fibrillation ablation
  • Randomized trial
  • Recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{f731b9e230324dba8d7a586d251d7078,
title = "Atorvastatin for prevention of atrial fibrillation recurrence following pulmonary vein isolation: A double-blind, placebo-controlled, randomized trial",
abstract = "Background: It is known that statins are effective in preventing atrial fibrillation (AF) in patients undergoing cardiac surgery. Objective: The purpose of this study was to evaluate the efficacy of statins in preventing AF recurrence following left atrial ablation. Methods: One hundred twenty-five patients who had no statin indication undergoing catheter ablation due to drug-refractory paroxysmal (n = 90) or persistent (n = 35) AF were randomized in a prospective, double-blind, placebo-controlled trial to receive 80 mg atorvastatin (n = 62) or placebo (n = 63) for 3 months. The primary endpoint was freedom from symptomatic AF at 3 months. Secondary endpoints included freedom from any atrial arrhythmia recurrence irrespective of symptoms, quality of life (QoL), and reduction in C-reactive protein (CRP). Results: At 3 months, 95{\%} of patients in the atorvastatin group were free of symptomatic AF compared with 93.5{\%} in the placebo group (P =.75). Similarly, 85{\%} of patients treated in the atorvastatin group remained free of any recurrent atrial arrhythmia vs 88{\%} of patients in the placebo group (P =.37). Mean CRP levels decreased in the atorvastatin group (mean change -0.75 ± 3, P =.02) and increased in the placebo group (mean change 2.1 ± 19.9, P =.48). Mean QoL score improved significantly in both groups (mean change 13.14 ± 18.2 in the atorvastatin group and 11.10 ± 17.7 in the placebo group, P =.53). Conclusion: In patients with no standard indication for statin therapy, treatment with atorvastatin 80 mg/day following AF ablation does not decrease the risk of AF recurrence in the first 3 months and should not be routinely administered to prevent periprocedural arrhythmias.",
keywords = "Atorvastatin, Atrial fibrillation ablation, Randomized trial, Recurrence",
author = "Mahmoud Suleiman and Celeste Koestler and Amir Lerman and Francisco Lopez-Jimenez and Regina Herges and David Hodge and Bradley, {David John} and Yong-Mei Cha and Brady, {Peter A.} and Munger, {Thomas M.} and Asirvatham, {Samuel J} and Packer, {Douglas L} and Friedman, {Paul Andrew}",
year = "2012",
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doi = "10.1016/j.hrthm.2011.09.016",
language = "English (US)",
volume = "9",
pages = "172--178",
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publisher = "Elsevier",
number = "2",

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TY - JOUR

T1 - Atorvastatin for prevention of atrial fibrillation recurrence following pulmonary vein isolation

T2 - A double-blind, placebo-controlled, randomized trial

AU - Suleiman, Mahmoud

AU - Koestler, Celeste

AU - Lerman, Amir

AU - Lopez-Jimenez, Francisco

AU - Herges, Regina

AU - Hodge, David

AU - Bradley, David John

AU - Cha, Yong-Mei

AU - Brady, Peter A.

AU - Munger, Thomas M.

AU - Asirvatham, Samuel J

AU - Packer, Douglas L

AU - Friedman, Paul Andrew

PY - 2012/2

Y1 - 2012/2

N2 - Background: It is known that statins are effective in preventing atrial fibrillation (AF) in patients undergoing cardiac surgery. Objective: The purpose of this study was to evaluate the efficacy of statins in preventing AF recurrence following left atrial ablation. Methods: One hundred twenty-five patients who had no statin indication undergoing catheter ablation due to drug-refractory paroxysmal (n = 90) or persistent (n = 35) AF were randomized in a prospective, double-blind, placebo-controlled trial to receive 80 mg atorvastatin (n = 62) or placebo (n = 63) for 3 months. The primary endpoint was freedom from symptomatic AF at 3 months. Secondary endpoints included freedom from any atrial arrhythmia recurrence irrespective of symptoms, quality of life (QoL), and reduction in C-reactive protein (CRP). Results: At 3 months, 95% of patients in the atorvastatin group were free of symptomatic AF compared with 93.5% in the placebo group (P =.75). Similarly, 85% of patients treated in the atorvastatin group remained free of any recurrent atrial arrhythmia vs 88% of patients in the placebo group (P =.37). Mean CRP levels decreased in the atorvastatin group (mean change -0.75 ± 3, P =.02) and increased in the placebo group (mean change 2.1 ± 19.9, P =.48). Mean QoL score improved significantly in both groups (mean change 13.14 ± 18.2 in the atorvastatin group and 11.10 ± 17.7 in the placebo group, P =.53). Conclusion: In patients with no standard indication for statin therapy, treatment with atorvastatin 80 mg/day following AF ablation does not decrease the risk of AF recurrence in the first 3 months and should not be routinely administered to prevent periprocedural arrhythmias.

AB - Background: It is known that statins are effective in preventing atrial fibrillation (AF) in patients undergoing cardiac surgery. Objective: The purpose of this study was to evaluate the efficacy of statins in preventing AF recurrence following left atrial ablation. Methods: One hundred twenty-five patients who had no statin indication undergoing catheter ablation due to drug-refractory paroxysmal (n = 90) or persistent (n = 35) AF were randomized in a prospective, double-blind, placebo-controlled trial to receive 80 mg atorvastatin (n = 62) or placebo (n = 63) for 3 months. The primary endpoint was freedom from symptomatic AF at 3 months. Secondary endpoints included freedom from any atrial arrhythmia recurrence irrespective of symptoms, quality of life (QoL), and reduction in C-reactive protein (CRP). Results: At 3 months, 95% of patients in the atorvastatin group were free of symptomatic AF compared with 93.5% in the placebo group (P =.75). Similarly, 85% of patients treated in the atorvastatin group remained free of any recurrent atrial arrhythmia vs 88% of patients in the placebo group (P =.37). Mean CRP levels decreased in the atorvastatin group (mean change -0.75 ± 3, P =.02) and increased in the placebo group (mean change 2.1 ± 19.9, P =.48). Mean QoL score improved significantly in both groups (mean change 13.14 ± 18.2 in the atorvastatin group and 11.10 ± 17.7 in the placebo group, P =.53). Conclusion: In patients with no standard indication for statin therapy, treatment with atorvastatin 80 mg/day following AF ablation does not decrease the risk of AF recurrence in the first 3 months and should not be routinely administered to prevent periprocedural arrhythmias.

KW - Atorvastatin

KW - Atrial fibrillation ablation

KW - Randomized trial

KW - Recurrence

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