The efficacy of Losartan in preventing recurrence of atrial fibrillation

Objective To evaluateive The efficacy of Losartan in maintenance of sinus rhythm after cardioversion of atrial o-level fibrillation(AF)and its influence on left atrial function. Methods 100 cases 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. Groupl was treated with amiodarone 0.2 qd plus Losartan 100mg qd in the same period, for 6 month. Group sⅡ was treated with amiodarone 0.2 qd in the same period. During 5 month of follow-up, electrocardiogram and 24-hour holter recording were performed for detection of recurrence of AFin the first week, second week, first month, second month, fourth monthand six months. The echocardiography examinations were performed on the next day and 6months after cardioversion to evaluate changes in left atrial function. Results After 6 month of follow-up , there were 16% AF recurrence of Group Ⅰ while 34% with AF recurrence of Group Ⅱ. there was a significant difference between the one groups (p0.05), the left atrial diameter (LAD, mm) measured by echocardiography on the next day and 6 months after cardioversion in Group Ⅱ was reduction (p0.01), while in Group Ⅰ, LAD did not show any significant reduction after six months(p0.05). Conclusions Combination of Losartan and amiodarone is more effective in maintenance of sinus rhythm after cardioversion of atrialo-level fibrillation (AF) than amiodarone alone. Long term treatment of Losartan may reverse LA enlargement, decrease LA pressure and prevent the recurrence of AF.