A Retrospective Analysis of the Use of ACE-inhibitors and Angiotensin Receptor Blockers

Completed

Conditions studied: Atrial Fibrillation, Atrial Flutter

In brief

It is well known that atrial fibrillation (AF) and atrial flutter occur frequently after most types of cardiac surgeries.(1-4) Postoperative AF is associated with significant morbidity, longer hospital stay, and higher related costs. Currently, it is common procedure to premedicate patients with antiarrhythmic drugs for elective cardiac surgeries. Treatments such as beta blockers, Amiodarone, and electrical pacing are used to help prevent the morbidity associated with pot-operative AF.(5) Renin-angiotensin system (RAS) activation may contribute to AF. Several clinical trials have suggested that inhibitors of this system may reduce the incidence of AF.(6-12) Patients with AF are known to have increased levels of angiotensin converting enzyme (ACE) and some types of angiotensin receptors.(13-15) Data from animal studies performed by our group suggest that cardiac ACE overexpression may lead to arrhythmic ion channel changes.(16;17) Although not studied in this group yet, it would be reasonable to conclude that the use of ACE inhibitors and angiotensin receptor blockers (ARBs) would decrease the incidence of AF in post-operative patients, too

Key facts

Study ID

NCT00321945

Run by

Emory University

People needed

546

Starts

2005-12-01

Expected to finish

2009-10-01

Last updated by the study team

2013-09-27

Who can join

Age: 18 and older, up to 65. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• All patients who underwent elective cardiac surgery in the Emory University Hospital, Crawford Long Hospital, or the VA Medical Center between 2000-2005.

You may not qualify if…

• Emergent operations.
• The presence of AF or atrial flutter at the time of surgery.
• Patients without adequate documentation of atrial rhythm following surgery.
• NYHA class IV heart failure at the time of surgery.
• Hyperthyroidism
• Implanted devices for designed for active management of atrial arrhythmias by pacing or defibrillation
• Known illicit drug use
• Known ethanol abuse
• Electrophysiological ablation for atrial tachycardia within 6 months of the operation.

Where it is running

• Emory University Hospital — Atlanta, Georgia, United States
• Crawford Long Hospital — Atlanta, Georgia, United States
• Veterans Administration Medical Center — Decatur, Georgia, United States

Full record on ClinicalTrials.gov

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