Inefficiency of renin-angiotensin inhibitors in preventing atrial fibrillation in patients with a normal heart

G. Fazio, C. Pizzuto, L. Sutera, D. Guttilla, G. Di Gesaro, C. Cascio, G. Novo, P. Assennato, S. Novo

Research output: Contribution to journalArticlepeer-review


Aim. Recent scientific evidence has emphasized the possible role of inhibitors of the renin-angiotensin system in preventing arrhythmic relapses in patients with paroxysmal or persistent atrial fibrillation and co-existing left ventricular hypertrophy or left ventricular dysfunction. Methods. In order to verify the effects of these drugs on patients with a normal heart, we collected a series of 187 patients admitted to our division of cardiology for paroxysmal or persistent atrial fibrillation. All patients underwent cardioversion (with antiarrhythmic drugs and/or by electrical cardioversion) and were discharged in sinus rhythm. Episodes of recurrent arrhythmia were recorded during a mean follow-up period was 2 years. Patients were subdivided into 2 groups according to therapy: group 1 comprised patients receiving renin-angiotensin system inhibitors, group 2 comprised those not receiving therapy with these agents. All 91 patients in group 1 and 76 of those in group 2 had hypertension. Among the 91 patients in the group 1, 55 were treated with angiotensin-converting enzyme (ACE) inhibitors and 36 with angiotensin receptor blockers. There were no statistically significant differences in cardiovascular risk factors or antiarrhythmic drug use between the 2 groups. Results. In group 1, 83% of patients experienced 2 episodes. In group 2,86% of patients experienced 2 relapses. There was no statistically significant difference between the 2 groups (P=0.85). A subgroup analysis showed that treatment with angiotensin receptor blockers, β-blockers, diuretics, and calcium-channel blockers brought no advantage in sinus rhythm maintenance. Conclusion. In our sample of hypertensive patients with a healthy heart, treatment with ACE inhibitors showed no statistically significant advantage in the prevention of atrial fibrillation relapses.

Original languageEnglish
Pages (from-to)311-315
Number of pages5
JournalMinerva Cardioangiologica
Issue number3
Publication statusPublished - Jun 2007


  • Angiotensin-converting enzyme inhibitors
  • Atrial fibrillation
  • Heart

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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