Ueng Kwo-Chang, Tsai Tsung-Po, Yu Wen-Chung, Tsai Chin-Feng, Lin Ming-Cheng, Chan Kuei-Chuan, Chen Chung-Yin, Wu Der-Jinn, Lin Chung-Sheng, Chen Shih-Ann
Division of Cardiology and Cardiovascular Surgery, Institute of Medicine, Chung-Shan Medical University Hospital, Taichung, Taiwan.
Eur Heart J. 2003 Dec;24(23):2090-8. doi: 10.1016/j.ehj.2003.08.014.
This study aimed to assess whether enalapril could improve cardioversion outcome and facilitate sinus rhythm maintenance after conversion of chronic atrial fibrillation (AF).
Patients with chronic AF for more than 3 months were assigned to receive either amiodarone (200mg orally 3 times a day; group I: n=75) or the same dosage of amiodarone plus enalapril (10mg twice a day; group II: n=70) 4 weeks before scheduled external cardioversion. The end-point was the time to first recurrence of AF. In 125 patients (86.2%), AF was converted to sinus rhythm. Group II had a trend to a trend to a lower rate of immediate recurrence of AF than group I did (4.3% vs 14.7%, P=0.067). Kaplan-Meier analysis demonstrated a higher probability of group II remaining in sinus rhythm at 4 weeks (84.3% vs 61.3%, P=0.002) and at the median follow-up period of 270 days (74.3% vs 57.3%, P=0.021) than in group II.
The addition of enalapril to amiodarone decreased the rate of immediate and subacute arrhythmia recurrences and facilitated subsequent long-term maintenance of sinus rhythm after cardioversion of persistent AF.
本研究旨在评估依那普利是否能改善慢性心房颤动（AF）转复后的复律结果并促进窦性心律维持。
将慢性AF病程超过3个月的患者在预定体外复律前4周分为两组，一组接受胺碘酮治疗（口服200mg，每日3次；I组：n = 75），另一组接受相同剂量的胺碘酮加依那普利治疗（口服10mg，每日2次；II组：n = 70）。终点为AF首次复发时间。125例患者（86.2%）AF转复为窦性心律。II组AF即刻复发率有低于I组的趋势（4.3%对14.7%，P = 0.067）。Kaplan-Meier分析显示，II组在4周时（84.3%对61.3%，P = 0.002）及中位随访期270天时（74.3%对57.3%，P = 0.021）维持窦性心律的概率高于I组。
胺碘酮联合依那普利可降低持续性AF复律后即刻及亚急性心律失常复发率，并促进随后窦性心律的长期维持。
