Clinical observations of ramipril and telmisartan combined with amiodarone in patients with paroxysmal atrial fibrillation

ZHAO Mei-li; LIU Da-Jun

doi:10.3760/cma.j.issn.1673-4777.2010.04.007

Abstract：Objective To evaluate the clinical efficacy of ramipril and telmisartan combined with amioda-rone on maintenance of sinus rhythm in patients with idiopathic paroxysmal atrial fibrillation(PAF). Methods One hundred and eighty patients with idiopathic PAF were included in the study and randomly divided into three groups: group A (Amiodarone group, n=61) was treated with amiodarone alone; group B (Amiodarone plus Ramipril, n=59) was treated with amiodarone combined with Ramipril;group C(Amiodarone plus telmisartan group,n=60)was trea-ted with amiodarone combined with telmisartan. The left atrial diameter(LAD) was measured with transthoracic echo-cardiogram before and 6,12,18 and 24 month after treatment. The follow-up was up to 2 years and the primary end point of the study was the first recurrence of AF. Results During the 6 months follow-up, there was no difference in LAD among three groups. After 12 months, LAD in group A was significantly larger than that in group B and group C(P<0.05). At the end of 12 months, the sinus rhythm maintenance of group A was lower significantly than that of group B and group C. At the end of the study, the maintenance of sinus rhythm in group B and group C was higher significantly than that in group A(77.78% and 78.57 % vs 58.62% (P<0.05). Nevertheless, there was no significant difference between group B and group C. Conclusions The results of this study suggest that the combination of amiodarone with Ramipril or telmisartan is more effective than amiodarone alone in sinus rhythm maintenance for idiopathic PAF and may restrain the enlargement of left atrium.