Yamashita Takeshi
The Cardiovascular Institute.
Nihon Rinsho. 2007 Mar;65(3):569-74.
Many recent mega-trials regarding atrial fibrillation have failed to prove the efficacy of antiarrhythmic drugs to improve the mortality and morbidity of patients with atrial fibrillation. Meanwhile, the upstream therapy of atrial fibrillation, the management of many components that lead to atrial fibrillation, has been paid much attention to, because its target would be the causes of atrial fibrillation itself. Among many upstream therapies, the blockade of the renin-angiotensin system would be promising from basic and clinical viewpoints, and also from rhythm management and stroke prevention.
近期许多关于心房颤动的大型试验均未能证明抗心律失常药物可改善心房颤动患者的死亡率和发病率。与此同时，心房颤动的上游治疗，即对导致心房颤动的诸多因素的管理，已备受关注，因为其目标直指心房颤动本身的病因。在众多上游治疗方法中，从基础和临床角度，以及从节律管理和预防中风方面来看，肾素 - 血管紧张素系统的阻断颇具前景。
