engleski

Can ACE inhibitors prevent atrial fibrillation in patients with tachy-brady syndrome treated by rate adaptive dual chamber pacemaker?

Aim. This study was performed to evaluate whether ACE inhibitors prevent atrial fibrillation (AF) in patients with tachy-brady syndrome treated by rate adaptive dual chamber (DDDR) pacemakers. Methods. Fifty consecutive patients with tachy-brady syndrome who underwent implantation of DDDR pacemaker were enrolled and retrospectively evaluated. Regarding to treatment with ACE inhibitors, the patients were divided in the two groups: treated (n=29) and nontreated (n=21) group. The primary end point was the development of permanent AF. Results. At baseline evaluation there was no difference in age, gender, underlying heart disease, heart failure and antiarrhythmic drug therapy between the two groups. During the mean follow-up period of 24 months, permanent AF developed in 10 patients with an overall incidence of 20%, while paroxysmal AF ocurred in 15 (30%) patients. The incidence of permanent AF at 1-year and 2-years was lower in patients treated with ACE inhibitors, as compared with those not taking these drugs. However, this difference was not statisticaly significant (6.8%. vs 14.2%, p=0.700, and 7.43% vs 16.79%, p=0.567, respectively). On the other side, the incidence of paroxysmal AF was significantly lower in patients treated with ACE inhibitors (10% vs 57%, p=0.001). Conclusion. The results of this study suggest that ACE inhibitors may have a beneficial effect in the prevention of AF in patients with tachy-brady syndrome. However, larger prospective studies are required to confirm these results.

ACE inhibitors; atrial fibrrillation; tachy-brady syndrome

Poster session 1: Antiarrhythmic and non antiarrhytmic agents ; P 16-4