Department of Cardiology and Atrial Fibrillation Center, The First Affiliated HospitalCollege of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province, People's Republic of China.
Department of Cardiology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, 318000, People's Republic of China.
Cardiovasc Drugs Ther. 2023 Jun;37(3):549-560. doi: 10.1007/s10557-022-07315-1. Epub 2022 Feb 9.
This study compared the effectiveness of sacubitril/valsartan (SV) vs. valsartan (V) for treating persistent atrial fibrillation (AF) after radio-frequency catheter ablation (RFCA).
Patients with persistent AF who received RFCA were randomly assigned to the SV or V treatment group with the intervention lasting for 12 months. The primary outcome included any atrial arrhythmia episode lasting ≥ 30 s after a 3-month blanking period. The secondary outcome included any atrial arrhythmia episode lasting ≥ 24 h or requiring cardioversion after a 3-month blanking period. The H2FPEF score was used to assess the possibility of patients suffering from heart failure with preserved ejection fraction.
A total of 143 patients with persistent AF who received RFCA were randomized for the study, with 5 patients failing to follow-up. Among them, 29 (42%) out of 69 patients receiving V and 15 (21.7%) out of 69 patients receiving SV reached the primary endpoint (P < 0.001). A total of 26 (37.7%) out of 69 patients receiving V and 7 (10.1%) out of 69 patients receiving SV reached the secondary endpoint (P < 0.001). A decrease in the H2FPEF score after a 1-year follow-up seemed to be related to the recurrence of AF (OR, 0.065; 95% CI: 0.018-0.238, P < 0.001).
SV can decrease AF recurrence after catheter ablation in patients with persistent AF at the 1-year follow-up. The mechanism for this process may be related to the reduction in the H2FPEF score in patients with preserved ejection fraction heart failure.
本研究比较了沙库巴曲缬沙坦（SV）与缬沙坦（V）在射频导管消融（RFCA）后治疗持续性心房颤动（AF）的疗效。
接受 RFCA 的持续性 AF 患者被随机分配到 SV 或 V 治疗组，干预持续 12 个月。主要结局包括在 3 个月空白期后持续≥30s 的任何房性心律失常发作。次要结局包括在 3 个月空白期后持续≥24h 或需要电复律的任何房性心律失常发作。使用 H2FPEF 评分评估患者心力衰竭伴射血分数保留的可能性。
共有 143 例接受 RFCA 的持续性 AF 患者被随机分组进行研究，5 例患者失访。其中，29 例（42%）接受 V 治疗的 69 例患者和 15 例（21.7%）接受 SV 治疗的 69 例患者达到主要终点（P<0.001）。26 例（37.7%）接受 V 治疗的 69 例患者和 7 例（10.1%）接受 SV 治疗的 69 例患者达到次要终点（P<0.001）。1 年后随访时 H2FPEF 评分下降似乎与 AF 复发有关（OR，0.065；95%CI：0.018-0.238，P<0.001）。
SV 可降低持续性 AF 患者经导管消融后 1 年 AF 的复发率。这一过程的机制可能与射血分数保留性心力衰竭患者 H2FPEF 评分的降低有关。
