Antihypertensive therapy reduces the risk of atrial fibrillation modestly but benefits appear to be larger in patients with heart failure , with no clear evidence of benefit in patients without heart failure .
Previous suggestions of class-specific effects could not be confirmed in this more comprehensive analysis
AIMS High blood pressure is known to be associated with future risk of atrial fibrillation .
Whether such risks can be reduced with antihypertensive therapy is less clear .
We conducted a systematic review and meta- analysis of large-scale r and omized trials that have reported the effect of antihypertensive agents on atrial fibrillation .
Antiarrhythmic effect of carvedilol after acute myocardial infarction: results of the Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN) trial.
OBJECTIVES Whether beta-blockers reduce atrial arrhythmias and , when added to an angiotensin-converting enzyme ( ACE ) inhibitor , ventricular arrhythmia is unknown . BACKGROUND Ventricular and atrial arrhythmias are common after acute myocardial infa rct ion ( AMI ) and are associated with a poor prognosis . Angiotensin-converting enzyme inhibitors reduce the incidence of both types of arrhythmia . METHODS The antiarrhythmic effect of carvedilol was examined in a placebo-controlled multicenter trial , the Carvedilol Post-Infa rct Survival Control in Left Ventricular Dysfunction ( CAPRICORN ) study , which enrolled 1,959 patients with reduced left ventricular systolic function after AMI , 98 % of whom were treated with an ACE inhibitor .  RESULTS The incidence of atrial fibrillation/flutter was 53 to 984 ( 5.4 % ) in the placebo group and 22 to 975 ( 2.3 % ) in the carvedilol group , giving a carvedilol/placebo  hazard ratio ( HR ) of 0.41 ( 95 % confidence interval [ CI ] 0.25 to 0.68 ; p = 0.0003 ) . The corresponding rates of ventricular tachycardia/flutter/fibrillation were 38 to 984 ( 3.9 % ) and 9 to 975 ( 0.9 % ) ( HR 0.24 , 95 % CI 0.11 to 0.49 ; p < 0.0001 ) . CONCLUSIONS Carvedilol has a powerful antiarrhythmic effect after AMI , even in patients already treated with an ACE inhibitor . Carvedilol suppresses atrial as well as ventricular arrhythmias in these patients
Antihypertensive therapy reduces the risk of atrial fibrillation modestly but benefits appear to be larger in patients with heart failure , with no clear evidence of benefit in patients without heart failure .
Previous suggestions of class-specific effects could not be confirmed in this more comprehensive analysis
AIMS High blood pressure is known to be associated with future risk of atrial fibrillation .
Whether such risks can be reduced with antihypertensive therapy is less clear .
We conducted a systematic review and meta- analysis of large-scale r and omized trials that have reported the effect of antihypertensive agents on atrial fibrillation .