|
Background and Purpose atrial fibrillation (AF) is the clinical practice, the most common sustained arrhythmia accounts due to arrhythmia hospitalization for 1/3 of the patients. According to statistics, the incidence of atrial fibrillation accounted for 0.4% to 1% of the general population and increases with age. Cross-stratified study found that <50 years of age the incidence of <0.1%, 60-year-old population incidence> 1% over the age of 80, 6%. The Framingham study found that people over the age of 30, an increase of 2% every 20 years, the incidence of AF. Over the past 20 years, due to a combination of factors (including the impact of the aging population, chronic heart disease increased incidence and diagnosis of atrial fibrillation rate increase after the application of dynamic testing equipment), resulted in a 66% increase in hospitalization due to atrial fibrillation patients. In general, the annual cost of treatment of patients is about 3,600 dollars, and has become a huge burden to society, even with the best treatment, still seriously affect the quality of life of patients, which urged people to look for drugs can prevent atrial fibrillation. Born in the nineties of the last century, the angiotensin II receptor antagonist (ARB) are widely used in the treatment of hypertension and related target organ protection through its blockade of the renin - angiotensin system and become a cardiovascular a milestone in the field of the treatment, the results of a series of clinical trials were prompted renin - angiotensin - aldosterone system (RAAS) inhibition of preventable occurrence and recurrence of atrial fibrillation. But affect the success rate for cardioversion of atrial fibrillation with angiotensin II receptor blocker (ARB) and the recent recurrence rate, results of various reports vary. In this paper, the prospective observational explore candesartan success rate of cardioversion for atrial fibrillation and the impact of the recent recurrence rate. The research methods selected from January 2005 to October 2006, the First Affiliated Hospital of Zhengzhou University Cardiovascular Medicine 99 routine drugs or electrical cardioversion of atrial fibrillation patients, their presence or absence taking candesartan cilexetil tablets were divided into two groups, group A (control group) 34 cases, including 22 males and 12 females, aged 41 to 87 years old (64.0 ± 12.7) years old on average, give amiodarone or propafenone hydrochloride and anticoagulation or antiplatelet therapy , amiodarone 200 ~~ 600 mg / d, propafenone hydrochloride 300 ~ 450mg / d, and 75 ~ 300mg / d or warfarin sodium tablets (warfarin sodium tablets dosage given according to the risk stratification of patients taking aspirin enteric-coated tablets PT-INR international normalized ratio adjustment, to maintain the PT-INR 2.0 to 3.0); B group (candesartan group) 65 cases, 37 males and 28 females, aged 23 to 92 years (mean 62.2 ± 15.1) years old, basic treatment with group A (as described above), 1 to 2 weeks prior to the basic treatment of oral candesartan cilexetil tablets 8mg / d. Cardioversion success rate observed in both groups, and two months after the recurrence rate. All measurement data were expressed as mean ± standard deviation ((?) ± s) said, using t test, count data are expressed as a percentage, X ~ 2 test. P <0.05 was considered statistically significant. Results A, B two groups in cardioversion success rate and recurrence rate difference was statistically significant (P <0.05), group B cardioversion success rate is higher than the A group (46/65 vs 15/34, P <0.05) recent relapse rate is lower than in group A (17/65 vs 18/34, P <0.01), in age, gender, left atrial diameter, left ventricular diameter, left ventricular ejection fraction, the difference was not statistically significant (P> 0.05), (the above results are shown in Table 1). Candesartan group, no adverse reactions occur. Conclusions on the basis of the conventional treatment of drug or electrical cardioversion associated with angiotensin II receptor antagonists can improve the success rate of cardioversion of atrial fibrillation to reduce recent relapse rate.
|