Prevention of atrial fibrillation in patients with aortic valve stenosis with candesartan treatment after aortic valve replacement

Jordi S. Dahl, Lars Videbæk, Mikael K. Poulsen, Patricia A. Pellikka, Karsten Veien, Lars Ib Andersen, Torben Haghfelt, Jacob E. Møller

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Accumulating data has suggested that treatment with Angiotensin-II receptor antagonists can prevent the new onset of atrial fibrillation (AF). The aim of this study was to evaluate whether treatment with candesartan on top of conventional treatment could prevent new onset AF in patients with aortic valve stenosis (AS) after aortic valve replacement. Methods and results: The study was a single centre, consecutive; investigator initiated study using a prospective randomised blinded endpoint design. 91 patients with severe AS without known AF scheduled for aortic valve replacement (AVR) were randomised to candesartan 32 mg once daily on top of conventional treatment or conventional therapy immediately after AVR. Patients were examined with ECG 3, 6, 9 and 12 months after surgery, and Holter-ECG analysis after 3 and 12 months. Primary endpoint was episode of AF with a duration exceeding 30 s, on the ECG or Holter-ECG and/or patients hospitalised due to AF. 14 patients developed new onset AF during follow up. AF-free survival was significantly higher (94% vs 74%, p = 0.02) in patients treated with candesartan. Conclusion: In patients with symptomatic severe AS undergoing AVR, treatment with candesartan may prevent the new onset of atrial fibrillation.

Original languageEnglish (US)
Pages (from-to)242-246
Number of pages5
JournalInternational Journal of Cardiology
Volume165
Issue number2
DOIs
StatePublished - May 10 2013

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Keywords

  • Angiotensin-II blockers
  • Aortic valve stenosis
  • Atrial fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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