Eplerenone in Patients with Persistent Atrial Fibrillation after Catheter Ablation

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概要

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• <B>Introduction:</B> There are several reports that suppression of the renin-angiotensin-aldosterone (RAA) system can prevent new-onset of atrial fibrillation (AF) and AF recurrence after cardioversion in clinical practice. However, there is no study that demonstrated the relation between the use of a selective aldsterone blocker and clinical outcomes after catheter ablation of AF. The purpose of this study is to investigate the effect of eplerenone, a selective aldosterone blocker, on clinical outcomes after ablation of persistent AF. <B>Methods:</B> This study included 139 consecutive patients with long-standing persistent AF undergoing catheter ablation between Nov. 2007 and Oct. 2010. The drugs used were eplerenone in 40 patients (eplerenone group), and either (non-eplerenone group) angiotensin converting enzyme inhibitor or angiotensin type 1 receptor blocker in the remaining patients. <B>Results:</B> After 24 months follow-up, 55.4% of patients were AF recurrences. Kaplan-Meier curve of free from AF recurrence showed that the rate of recurrence in eplerenone group was 60% and the rate of recurrence in non-eplerenone group was 39% (P<0.05 by log rank test). In cox regression analysis, only eplerenone therapy significantly reduced AF recurrence (HR=0.522; 95% CI 0.294–0.927, P<0.05). <B>Conclusion:</B> Eplerenone can reduce the rate of recurrent AF after catheter ablation in patients with long-standing persistent AF.

著者

• Tada Hiroshi

  Cardiology Department of Internal Medicine, Univercity of Tsukuba Graduate School of Comprehensive H

• Murakoshi Nobuyuki

  Cardiovascular division, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Igarashi Miyako

  Cardiovascular division, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Yoshida Kentaro

  Cardiology Department of Internal Medicine, University of Tsukuba Graduate School of Comprehensive H

• Sekiguchi Yukio

  Cardiology Department Of Internal Medicine University Of Tsukuba Graduate School Of Comprehensive Hu

• Aonuma Kazutaka

  Cardiology Department Of Internal Medicine University Of Tsukuba Graduate School Of Comprehensive Hu

• Murakoshi Nobuyuki

  Cardiology Department Of Internal Medicine University Of Tsukuba Graduate School Of Comprehensive Hu

• Nakano Emi

  Cardiovascular Division Kawasaki Municipal Tama Hospital

• Naruse Yoshihisa

  Cardiovascular Division Institute Of Clinical Medicine Graduate School Of Comprehensive Human Sciences University Of Tsukuba

• ITO Yoko

  Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• KANESHIRO Takashi

  Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Yoshida Kentaro

  Cardiovascular Division, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Tada Hiroshi

  Cardiovascular Division, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Yamsaki Hiro

  Cardiovascular Division, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Kunugita Fusanori

  Cardiovascular Division, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Kaneshiro Takashi

  Cardiovascular Division, Graduate School of Comprehensive Human Sciences, University of Tsukuba

• Igarashi Miyako

  Cardiovascular Division, Faculty of Medicine, University of Tsukuba

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