TY - JOUR
T1 - Randomized trial of angiotensin II-receptor blocker vs. dihydropiridine calcium channel blocker in the treatment of paroxysmal atrial fibrillation with hypertension (J-RHYTHM II Study)
AU - Yamashita, Takeshi
AU - Inoue, Hiroshi
AU - Okumura, Ken
AU - Kodama, Itsuo
AU - Aizawa, Yoshifusa
AU - Atarashi, Hirotsugu
AU - Ohe, Tohru
AU - Ohtsu, Hiroshi
AU - Kato, Takao
AU - Kamakura, Shiro
AU - Kumagai, Koichiro
AU - Kurachi, Yoshihisa
AU - Koretsune, Yukihiro
AU - Saikawa, Tetsunori
AU - Sakurai, Masayuki
AU - Sato, Toshiaki
AU - Sugi, Kaoru
AU - Nakaya, Haruaki
AU - Hirai, Makoto
AU - Hirayama, Atsushi
AU - Fukatani, Masahiko
AU - Mitamura, Hideo
AU - Yamazaki, Tsutomu
AU - Watanabe, Eiichi
AU - Ogawa, Satoshi
PY - 2011/4
Y1 - 2011/4
N2 - Aims: Atrial fibrillation (AF) is a common arrhythmia frequently associated with hypertension. This study was designed to test the hypothesis that lowering blood pressure by angiotensin II-receptor blockers (ARB) has more beneficial effects than by conventional calcium channel blockers (CCB) on the frequency of paroxysmal AF with hypertension. Methods and results: The Japanese Rhythm Management Trial II for Atrial Fibrillation (J-RHYTHM II study) is an open-label randomized comparison between an ARB (candesartan) and a CCB (amlodipine) in the treatment of paroxysmal AF associated with hypertension. Using daily transtelephonic monitoring, we examined asymptomatic and symptomatic paroxysmal AF episodes during a maximum 1 year treatment. The primary endpoint was the difference in AF frequency between the pre-treatment period and the final month of the follow-up. The secondary endpoints included cardiovascular events, development of persistent AF, left atrial dimension, and quality-of-life (QOL). The study enrolled 318 patients (66 years, male/female 219/99, 158 in the ARB group and 160 in the CCB group) treated at 48 sites throughout Japan. At baseline, the frequency of AF episodes (days/month) was 3.8 ± 5.0 in the ARB group vs. 4.8 ± 6.3 in the CCB group (not significant). During the follow-up, blood pressure was significantly lower in the CCB group than in the ARB group (P < 0.001). The AF frequency decreased similarly in both groups, and there was no significant difference in the primary endpoint between the two groups. There were no significant differences between the two groups in the development of persistent AF, changes in left atrial dimension, occurrence of cardiovascular events, or changes in QOL. Conclusions: In patients with paroxysmal AF and hypertension, treatment of hypertension by candesartan did not have an advantage over amlodipine in the reduction in the frequency of paroxysmal AF (umin CTR C000000427). Published on behalf of the European Society of Cardiology. All rights reserved.
AB - Aims: Atrial fibrillation (AF) is a common arrhythmia frequently associated with hypertension. This study was designed to test the hypothesis that lowering blood pressure by angiotensin II-receptor blockers (ARB) has more beneficial effects than by conventional calcium channel blockers (CCB) on the frequency of paroxysmal AF with hypertension. Methods and results: The Japanese Rhythm Management Trial II for Atrial Fibrillation (J-RHYTHM II study) is an open-label randomized comparison between an ARB (candesartan) and a CCB (amlodipine) in the treatment of paroxysmal AF associated with hypertension. Using daily transtelephonic monitoring, we examined asymptomatic and symptomatic paroxysmal AF episodes during a maximum 1 year treatment. The primary endpoint was the difference in AF frequency between the pre-treatment period and the final month of the follow-up. The secondary endpoints included cardiovascular events, development of persistent AF, left atrial dimension, and quality-of-life (QOL). The study enrolled 318 patients (66 years, male/female 219/99, 158 in the ARB group and 160 in the CCB group) treated at 48 sites throughout Japan. At baseline, the frequency of AF episodes (days/month) was 3.8 ± 5.0 in the ARB group vs. 4.8 ± 6.3 in the CCB group (not significant). During the follow-up, blood pressure was significantly lower in the CCB group than in the ARB group (P < 0.001). The AF frequency decreased similarly in both groups, and there was no significant difference in the primary endpoint between the two groups. There were no significant differences between the two groups in the development of persistent AF, changes in left atrial dimension, occurrence of cardiovascular events, or changes in QOL. Conclusions: In patients with paroxysmal AF and hypertension, treatment of hypertension by candesartan did not have an advantage over amlodipine in the reduction in the frequency of paroxysmal AF (umin CTR C000000427). Published on behalf of the European Society of Cardiology. All rights reserved.
UR - http://www.scopus.com/inward/record.url?scp=79953776126&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79953776126&partnerID=8YFLogxK
U2 - 10.1093/europace/euq439
DO - 10.1093/europace/euq439
M3 - Article
C2 - 21148662
AN - SCOPUS:79953776126
SN - 1099-5129
VL - 13
SP - 473
EP - 479
JO - Europace
JF - Europace
IS - 4
ER -