Atrial Fibrillation Clinical Trial
The purpose of this study is to test the hypothesis that treatment with the angiotensin II type 1 receptor antagonist candesartan may reduce the recurrence rate of atrial fibrillation after electrical cardioversion.
Background: The most effective procedure to restore sinus rhythm in patients with persistent
atrial fibrillation (AF) is electrical cardioversion, but AF recurs in 60-80% of the
patients during the first year. AF is associated with electrical and anatomical remodelling
of the atria, and angiotensin II is involved in the remodelling process. Studies have
indicated that the angiotensin II type 1 receptor antagonist candesartan may counteract both
electrical and anatomical remodelling induced by AF. The investigators therefore
hypothesised that treatment with candesartan may reduce the recurrence rate of AF after
electrical cardioversion.
Study design: 171 patients with persistent AF scheduled for electrical cardioversion are
randomised in a double blind, placebo-controlled study. The patients receive tablets of
candesartan 8 mg or matching placebo once daily for 3-6 weeks before cardioversion, and
candesartan 16 mg or matching placebo once daily for 6 months after cardioversion. The study
medication is discontinued if electrical cardioversion is unsuccessful or if AF recurrence
is documented. Primary endpoint is recurrence of AF. Clinical, electrocardiographic,
echocardiographic and biochemical markers will be analysed.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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