Review Article

Novel Pharmacological Interventions to Maintain Sinus Rhythm after DC Cardioversion

Table 1


StudyStudy designNFollowup (months)ACE/ARBComparator drugMain findings

Van den Berg et al. [59]Randomised, double blind181.5LisinoprilPlaceboMaintenance of SR: 71% with lisinopril versus 36% with placebo

Madrid et al. [28]Randomised, open label1542IrbesartanNo irbesartanReduction in the risk of AF recurrence with irbesartan: adjusted HR (95% CI): 0.19 (0.04–0.86); 𝑃 = 0 . 0 3

Ueng et al. [29]Randomised, open label1459EnalaprilNo enalaprilRecurrence of AF: 4.3% with enalapril versus 14.7% without, 𝑃 = 0 . 0 6 7 . Probability of remaining in SR at 4 weeks: 84.3 versus 61.3%, 𝑃 = 0 . 0 0 2 .
Adjusted HR (95% CI): 0.37 (0.12–1.15); 𝑃 = 0 . 0 4 1

Madrid et al. [27]Randomised, open label607.3Irbesartan
(+amiodarone)
No irbesartanPatients remaining free of AF at 1 yr: irbesartan 300 mg + amiodarone = 77%, irbesartan 150 mg + amiodarone = 65%, amiodarone alone = 52% ( 𝑃 = 0 . 0 0 1 versus irbesartan 300 mg + amiodarone)

Grecu et al. [56]Randomised, open label3612Perindopril
(+Propafenone)
PlaceboMaintenance of SR: 37% with perindopril versus 20% with placebo. Time interval to recurrences was significantly higher in ACEI-treated patients (7.06 ± 1.02 versus 4.50 ± 0.93 months; 𝑃 = 0 . 0 3 4 )

Tveit et al. [57] (CAPRAF study)Randomised, double blind1376CandesartanPlaceboRecurrence of AF: 71% with candesartan versus 65% with placebo 𝑃 = n s

Belluzzi et al. [60]Randomised, double blind6236RamiprilPlaceboRecurrence of AF: 10% with ramipril versus 32% with placebo ( 𝑃 < 0 . 0 3 , Kaplan-Meier, log-rank test)

Disertori et al. [58] (GISSI-AF)Randomised, double blind1,44212ValsartanPlaceboRecurrence of AF: 51.4% with valsartan versus 52.1% with placebo.
Adjusted HR (96% CI): 0.97 (0.83–1.14); 𝑃 = 0 . 7 3