Beneficial effects of losartan for prevention of paroxysmal atrial fibrillation in patients with sick sinus syndrome: analysis with memory function of pacemaker

Autor: Shogo Ito, Tsutomu Imaizumi, Tomohito Inage, Yoshihiro Fukuomoto, Takeki Gondo, Go Haraguchi, Eiichi Takii, Masatsugu Ohe, Teruhisa Yoshida, Jun Kumanomido
Rok vydání: 2015
Předmět:
Male
Pacemaker
Artificial
medicine.medical_specialty
Angiotensin receptor
Time Factors
Hemodynamics
030204 cardiovascular system & hematology
Asymptomatic
Losartan
Sick sinus syndrome
Renin-Angiotensin System
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Japan
Biological Clocks
Predictive Value of Tests
Internal medicine
Atrial Fibrillation
Renin–angiotensin system
Secondary Prevention
medicine
Humans
Prospective Studies
030212 general & internal medicine
Aged
Sinoatrial Node
Sick Sinus Syndrome
business.industry
Cardiac Pacing
Artificial
Signal Processing
Computer-Assisted
Atrial fibrillation
Equipment Design
medicine.disease
Cardiac surgery
Treatment Outcome
Anesthesia
Cardiology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Angiotensin II Type 1 Receptor Blockers
Anti-Arrhythmia Agents
medicine.drug
Zdroj: Heart and Vessels. 31:402-407
ISSN: 1615-2573
0910-8327
Popis: Renin–angiotensin system (RAS) inhibitors may be useful in preventing the occurrence of paroxysmal atrial fibrillation (PAF). However, evaluation of such effect is difficult because many PAF episodes are asymptomatic and not all episodes are detected by intermittent electrocardiographic monitoring. A pacemaker has been developed with dedicated functions for AF detection and electrocardiogram storage. Accordingly, we examined the effect of losartan, an angiotensin receptor blocker on PAF occurrence using this new modality. We enrolled 70 consecutive patients who had undergone dual-chamber pacemaker implantation for sick sinus syndrome. Finally, 62 patients participated in the study. Thirty patients were randomized to the losartan group (mean 43 ± 12 mg/day) and 32 patients to the control group. They were followed up for 3 months. The frequency, the maximum duration and the total duration of PAF recorded by the stored electrocardiograms for the last 1 month during the observation period and study period were compared between the two groups. The change in the frequency of PAF from the observation period in the losartan and control groups was similar (−35 ± 25 vs. −67 ± 62 times; NS). However, the change in the maximum duration and the total duration of PAF was significantly shorter in the losartan group than in the control group (−493 ± 158 vs. −10 ± 69 min; p < 0.05, and −4007 ± 2334 vs. 1119 ± 714 min; p < 0.05, respectively). Losartan suppressed the maximum duration and the total duration of PAF in patients with sick sinus syndrome without hemodynamic changes. This is the first study to show the effect of a renin–angiotensin system inhibitor on the secondary prevention of PAF using the dedicated functions of a pacemaker for PAF detection and electrocardiogram storage.
Databáze: OpenAIRE
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