Effect of telmisartan on paroxysmal atrial fibrillation recurrence in hypertensive patients with normal or increased left atrial size

Clinical Cardiology, 04/27/2012

Telmisartan was more effective than amlodipine in preventing atrial fibrillation (AF) recurrences in hypertensive patients with paroxysmal AF.

Methods

  • The authors assigned 378 mild hypertensive outpatients in sinus rhythm, but with ≥2 episodes of AF in the previous 6 months, to 1 of 2 groups.
  • Group 1 comprised patients with LAD <40 mm in females and <45 mm in males.
  • Group 2 comprised patients with LAD >40 mm and <45 mm in females and >45 mm and <50 mm in males.
  • In both groups, patients were randomly treated with telmisartan or amlodipine for 1 year.

Results

  • Systolic and diastolic blood pressure were similarly reduced by telmisartan and amlodipine in both groups.
  • The AF recurrence rate was significantly lower in the telmisartan–treated patients than in the amlodipine–treated patients in both group 1 (12 vs 39, P < 0.01) and group 2 (40 vs 59, P < 0.05).
  • Under telmisartan, the AF recurrence rate was significantly lower in group 1 than in group 2 (12.9% vs 42.1%, P < 0.05).
  • Time to a first AF relapse was significantly longer with telmisartan than with amlodipine in both group 1 (176 ± 94 days vs 74 ± 61 days, P < 0.05) and group 2 (119 ± 65 days vs 38 ± 35 days, P < 0.05).

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