Use of enalapril to facilitate sinus rhythm maintenance after external cardioversion of long-standing persistent atrial fibrillation. Results of a prospective and controlled study
Abstract
AIMS: This study aimed to assess whether enalapril could improve cardioversion outcome and facilitate sinus rhythm maintenance after conversion of chronic atrial fibrillation (AF). METHODS AND RESULTS: Patients with chronic AF for more than 3 months were assigned to receive either amiodarone (200mg orally 3 times a day; group I: n=75) or the same dosage of amiodarone plus enalapril (10mg twice a day; group II: n=70) 4 weeks before scheduled external cardioversion. The end-point was the time to first recurrence of AF. In 125 patients (86.2%), AF was converted to sinus rhythm. Group II had a trend to a trend to a lower rate of immediate recurrence of AF than group I did (4.3% vs 14.7%, P=0.067). Kaplan-Meier analysis demonstrated a higher probability of group II remaining in sinus rhythm at 4 weeks (84.3% vs 61.3%, P=0.002) and at the median follow-up period of 270 days (74.3% vs 57.3%, P=0.021) than in group II. CONCLUSIONS: The addition of enalapril to amiodarone decreased the rate of immediate and subacute arrhythmia recurrences and facilitated subsequent long-term maintenance of sinus rhythm after cardioversion of persistent AF.
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ACE inhibitors or ARBs may reduce recurrent AF after cardioversion when coadministered with antiarrhythmic drug therapy compared with an antiarrhythmic drug alone.
“ACE inhibitors or ARBs may reduce recurrent AF after cardioversion when coadministered with antiarrhythmic drug therapy compared with an antiarrhythmic drug alone.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [249]
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- Authors
- Ueng, K.
- Affiliations
- Chung Shan Medical University Hospital (TW)
- Corresponding author
- Ueng, K
- ORCID
- Ueng, K
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-12
- Volume
- 24
- Issue
- 23
- Pages
- 2090-2098
- ISSN
- 0195-668X (ISSN-L)
- OpenAlex
- W1946485105
- Cited by
- 293
- References
- 45
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 6 · 2015: 7 · 2014: 6 · 2013: 13 · 2012: 9
- FWCI
- 13.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- enalapril, amiodarone, atrial fibrillation, external cardioversion, sinus rhythm maintenance, atrial fibrillation recurrence, long-standing persistent atrial fibrillation, combination anticoagulant therapy, ACE inhibitors
- MeSH terms
- Adolescent, Adult, Aged, Amiodarone, Angiotensin-Converting Enzyme Inhibitors, Anti-Arrhythmia Agents, Antihypertensive Agents, Atrial Fibrillation, Combined Modality Therapy, Drug Therapy, Combination, Electric Countershock, Enalapril, Humans, Long-Term Care, Middle Aged, Prospective Studies, Treatment Outcome, Disease-Free Survival, Secondary Prevention
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