Effects Of Valsartan On Prevention Of Atrial Fibrillation Following Dual-chamber Pacemaker Implantation In Patients With Sick Sinus Syndrome

Objective To evaluate the effect of valsartan on preventing paroxysmal atrial fibrillation(PAF)following dual-pacemaker implantation in patients with sick sinus syndrome(SSS) and the effect on heart remodelling. And observe the changes of patients’blood pressure after using valsartan.Subjects and methods87SSS patients with paroxysmal AF recurrence and occurrence following dual-chamber pacemaker insertion were randomized to the valsartan. group(n=44) and the control group(n=43). On the basis of the treatment of original diseases, the valsartan group were given valsartan,80mg served every night, the control group were not given any valsartan,AF times, AF duration, percentages of atrial pacing(AP)and ventricular pacing(VP) were monitored by pacemaker records every3months up to12months after randomization. Then AF burden(h/d) and incidence of persistent AF(AFepisodes lasting≥48h) were summarized during12months. Before and12th monthafter randomization, left atrial diameter(LAD)、LSIand LML were measured by Doppler echocardiography; at the same time, calculate Left atrial volume(LAV)=4/3×(LAD×LSI×LML/8). Use the calibration of mercury sphygmomanometer measure blood pressure.The above-mentioned indicators werecompared between the two groups over the same period as well as before and aftertreatment in the same group.Results6patients withdrew from the study because of taking Ⅰ or Ⅲ class antiarrhythmic drugs during the follow-up period, and41cases in the statin group,40cases in the control group actually completed the regular follow-up. After follow-up of12months. AF burden was significantly lower in patients receiving valsartan therapy when compared with mose not receiving valsartan therapy (0.395±0.285vs0.864±0.316h/d,(P<0.05). Additionally, the incidence of unhappened persistent AF in the control group was higher than that in the valsartan group(39/41vs35/40, P<0.05). At the end of study, LAV was smaller (42.4±12.1vs37.6±7.9ml, P<0.01), systolic pressure significantly lower in patients receiving valsartan therapy(116±7vs129±8mmHg, p<0.05) when commared with those of control group. There was no significant differences in the ab(?)mentioned indicators before and after treatment in the control group. There was no sign.ficant differences in the percentage of AP、VP and diastolic pressure before and after treatment between the two groups. Blood pressure lowering of two groups of patients were not causing dizziness、Sweating and palpitations.Potassium, creatinine were not seen the abnormal changes.Conclusion Valsartan can effectively inhibit the occurrence and progress ofparoxysmal AF after dual-chamber pacemaker implantation in patients with SSS, meanwhile reversing the left atrial structural remodeling. Patients can well tolerate the conventional dose of valsartan.