Renin Angiotenin Blocker Pre-treatment and Recurrence After Pulmonary Vein Isolation in Patients with Paroxysmal and Persistent Atrial Fibrillation. (Record no. 2376)

MARC details
000 -LEADER
fixed length control field 03216nam a22002897a 4500
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fixed length control field 170526s20132013 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 1941-6911
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
PMID 28496891
245 ## - TITLE STATEMENT
Title Renin Angiotenin Blocker Pre-treatment and Recurrence After Pulmonary Vein Isolation in Patients with Paroxysmal and Persistent Atrial Fibrillation.
251 ## - Source
Source Journal of Atrial Fibrillation. 6(3):898, 2013 Oct-Nov
252 ## - Abbreviated Source
Abbreviated source J Atr Fibrillation. 6(3):898, 2013 Oct-Nov
253 ## - Journal Name
Journal name Journal of atrial fibrillation
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Year 2013
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Manufacturer FY2014
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Date added to catalog 2017-05-26
520 ## - SUMMARY, ETC.
Abstract <b>Introduction:</b> Pulmonary venous isolation has emerged as an effective method for preventing atrial fibrillation (AF) recurrence. Yet, recurrence is common. Angiotensin-receptor-blockers (ARBs) and angiotensin-converting-enzyme-inhibitors (ACEI) are effective in reducing the extent of myocardial remodeling and fibrosis. Our aim was to study whether pretreatment with ARBs and ACEI was effective in decreasing recurrence after pulmonary vein isolation for patients with AF. <b>Methods:</b> Three hundred and twelve consecutive patients who underwent ablation from 12/2006 until 7/2010 were followed for at least one year. All patients underwent MRI before ablation to assess atrial fibrosis. Data include demographic characteristics, comorbidities, AF type and information regarding treatment with ACEI or ARBs. <b>Results:</b> Most patients were men (62%), mean age was 64. Hypertension (HTN) was present in 60%. Their mean ejection fraction was 60%. There were 104 patients (33.3%) treated with ACEI, and 13.5 % were treated with ARBs prior to ablation. Ninety seven patients (31.1%) had AF recurrence. AF type was a significant predictor for recurrence (recurrence with paroxysmal, persistent and long-standing persistent: 23.75, 37.3 and 60%, respectively, p=0.005). The most important factor predicting recurrence was increased pre-ablation atrial fibrosis (p<0.0001). Recurrence was more frequent in patients treated with ACEI (40.4% vs 26.4% untreated patients, p=0.012). In the ARB treated group, 38.1% vs 30.0% untreated experienced recurrence (p=0.3). After multivariable adjustment for demographics, risk factors and atrial fibrosis, treatment with ACEI was associated with increased rate of recurrence in patients with persistent AF (hazard ratio: 2.6, p=0.003). There was no significant relation between ACEI pretreatment and recurrence in patients with paroxysmal AF (HR- 0.83, p=0.7), or between ARB pre-treatment and recurrence in patients with paroxysmal as well as persistent AF (p=0.2 and 0.53, respectively). <b>Conclusions:</b> Pretreatment with ACEI or ARBs is not associated with reduced recurrence rate in patients with paroxysmal or persistent AF undergoing ablation.
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element PubMed-not-MEDLINE -- Not indexed
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Institution MedStar Harbor Hospital
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Department Medicine
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Medline publication type Journal Article
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Local Authors Rosen, Boaz D
790 ## - Authors
All authors Akoum N, Bader F, Burgon N, Marrouche N, Rosen BD, Vergara G
856 ## - ELECTRONIC LOCATION AND ACCESS
DOI <a href="https://dx.doi.org/10.4022/jafib.898">https://dx.doi.org/10.4022/jafib.898</a>
Public note https://dx.doi.org/10.4022/jafib.898
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Item type description Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection Home library Current library Date acquired Total Checkouts Full call number Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 05/26/2017   28496891 28496891 05/26/2017 05/26/2017 Journal Article

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