Efficacy of Valsartan in Preventing Atrial Fibrillation Recurrence and Atrial Remodeling

Objective:To evaluate the efficacy of Valsartan in maintenance of sinus rhythm after cardioversion of atrial fibrillation(AF)and its influence on atrial function.Methods:60 patients with persistent AF were randomly divided into two groups after cardioversion using either antiarrhythmic medicines or synchronized direct current.Two groups of patients were compared.GroupⅠ was treated with amiodarone 0.2 qd for 6 month,GroupⅡwas treated with amiodarone 0.2 qd plus Valsartan 80mg qd in the same period.During 6 month of follow-up,electrocardiogram and 24-hour holter recording were performed for detection of recurrence of AF in the first week,second week,first month,second month,fourth month and sixth month.The echocardiography examinations were performed on the next day and six months after cardioversion to evaluate changes in left atrial structure and function.Results:After 6 month of follow-up,there were33% AF recurrence of Group Ⅰ while 13% with AF recurrence of Group Ⅱ.There was a significant difference between the two groups(P0.05),the left atrial diameter(LAD,mm)measured by echocardiography on the next day and six months after cardioversion in Group Ⅱ was reduction(P0.05),while in Group Ⅰ,LAD did not show any significant reduction after six months(P0.05).Conclusion:Combination of Valsartan and amiodarone is more effective in maintenance of sinus rhythm after cardioversion of AF than amiodarone alone.Long term treatment of Valsartan may reverse LA enlargement,decrease LA pressure and prevent the recurrence of AF.