Irbesartan combined with Amiodarone versus Amiodarone alone for Paroxysmal Atrial Fibrillation:A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 LIYan-jun , LILe ,  TANGYan-hong

Cardiovascular Internal Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China;

Corresponding author：

TANGYan-hong, Email: wurmheart@vip.163.com

Keywords：

Irbesartan; Amiodarone; Paroxysmal atrial fibrillation; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20150178

Video：

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Objective To systematically review the efficacy of irbesartan combined with amiodarone versus amiodarone alone for paroxysmal atrial fibrillation. Methods We electronically searched databases including PubMed, CENTRAL, EMbase, VIP, CNKI and WanFang Data to collect randomized controlled trials (RCTs) about irbesartan combined with amiodarone versus amiodarone alone in the treatment of paroxysmal atrial fibrillation from 2000 to 2014. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of nine studies involving 998 patients were included. The results of meta-analysis showed that:Compared with the amiodarone group, the left atrial diameter was smaller (MD=-1.49, 95% CI -1.82 to -1.15), and the maintenance rates of sinus rhythm were higher (OR=3.02, 95%CI 2.21 to 4.11) in the irbesartan plus amiodarone group after 12 months. Conclusion Current evidence indicates that the combination treatment of irbesartan and amiodarone for paroxysmal atrial fibrillation is better than amiodarone alone in delaying the enlargement of left atrial diameter, as well as the maintenance of sinus rhythm. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： LIYan-jun, LILe, TANGYan-hong. Irbesartan combined with Amiodarone versus Amiodarone alone for Paroxysmal Atrial Fibrillation:A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(9): 1078-1083. doi: 10.7507/1672-2531.20150178 Copy

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2.	Nattel S. New ideas about atrial fibrillation 50 years on. Nature, 2002, 415(6868):219-226.
3.	Roy D, Talajic M, Dorian P, et al. Am iodarone to prevent recurrence of atrial fibrillation. N Engl J Med, 2000, 242(43):913-920.
4.	廖伟, 阳贻红, 严章林, 等. 厄贝沙坦联合胺碘酮治疗非瓣膜病阵发性心房颤动疗效观察. 山东医药, 2008, 48(7):66-67.
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7.	李超, 蒋勇, 韦玉华. 胺碘酮联合厄贝沙坦治疗阵发性房颤的临床观察. 柳州医学, 2011, 24(2):79-81.
8.	徐爱琴. 胺碘酮联合厄贝沙坦治疗阵发性心房颤动疗效观察. 2011, 15(11):1421-1422.
9.	冼飞, 潘俊泰. 胺碘酮联合厄贝沙坦治疗阵发性心房颤动疗效观察. 2011, 18(12):1894-1895.
10.	刘国伟, 周菊洪. 胺碘酮联合厄贝沙坦治疗非瓣膜性心脏病阵发性房颤的疗效分析. 江西医药, 2013, 48(6):521-523.
11.	刘超群, 席翌智. 胺碘酮联合厄贝沙坦治疗阵发性房颤的疗效及不良反应分析. 现代诊断与治疗, 2013, 24(17):3995-3996.
12.	张春德. 观察胺碘酮联合厄贝沙坦对阵发性房颤的疗效. 心血管病防治知识. 2014, 5(6):54-55.
13.	Medi C, Hankey GJ, Freedman SB. Stroke risk and antithrombotic strategies in atrial fibrillation. Stroke, 2010, 41(11):2705-2713.
14.	Corradi D. Atrial fibrillation from the pathologist's perspective. Cardiovasc Pathol, 2014, 23(2):71-84.
15.	Maan A, Mansour M, McManus DD, et al. Novel therapeutic targets in the management of atrial fibrillation. Am J Cardiovasc Drugs, 2014, 14(6):403-421.
16.	张勇, 杨宝峰. 心房颤动发病机制研究进展. 沈阳药科大学学报, 2011, 28(8): 680-686.
17.	Heijman J, Voigt N, Nattel S, et al. Cellular and molecular electrophysiology of atrial fibrillation initiation, maintenance, and progression. Circ Res, 2014, 114(9):1483-1499.
18.	Oakes RS, Badger TJ, Kholmovski EG, et al. Detection and quantification of left atrial structural remodeling with delayedenhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation, 2009, 119(13):1758-1767.
19.	苏德兴. 胺碘酮治疗心房颤动复律 124例临床分析. 中国民康医学. 2012, 24(2):161-162.
20.	Anand K, Mooss AN, Hee TT, et al. Meta-analysis:inhibition of reninangiotens in system prevents new-onset atrial fibrillation. Am Heart J, 2011, 152(9):217-222.
21.	Ji Q, Mei Y, Wang X, et al. Combination of irbesartan and amiodarone to maintain sinus rhythm in patients with persistent atrial fibrillation after rheumatic valve replacement. Circ J, 2010, 74(9):1873-1879.

1. 梁珍玲, 孙叶海, 彭卫平. 厄贝沙坦联合胺碘酮治疗阵发性心房颤动的疗效. 中国老年学杂志, 2012, 32(13):2836-2837.
2. Nattel S. New ideas about atrial fibrillation 50 years on. Nature, 2002, 415(6868):219-226.
3. Roy D, Talajic M, Dorian P, et al. Am iodarone to prevent recurrence of atrial fibrillation. N Engl J Med, 2000, 242(43):913-920.
4. 廖伟, 阳贻红, 严章林, 等. 厄贝沙坦联合胺碘酮治疗非瓣膜病阵发性心房颤动疗效观察. 山东医药, 2008, 48(7):66-67.
5. 邵明, 华晶. 厄贝沙坦联合胺碘酮治疗阵发性心房颤动的临床研究. 现代实用医学, 2009, 21(7):751-752.
6. 石新国, 李霞, 张华. 胺碘酮与厄贝沙坦联合治疗阵发性房颤的临床观察. 新疆医学, 2010, 40(5):38-40.
7. 李超, 蒋勇, 韦玉华. 胺碘酮联合厄贝沙坦治疗阵发性房颤的临床观察. 柳州医学, 2011, 24(2):79-81.
8. 徐爱琴. 胺碘酮联合厄贝沙坦治疗阵发性心房颤动疗效观察. 2011, 15(11):1421-1422.
9. 冼飞, 潘俊泰. 胺碘酮联合厄贝沙坦治疗阵发性心房颤动疗效观察. 2011, 18(12):1894-1895.
10. 刘国伟, 周菊洪. 胺碘酮联合厄贝沙坦治疗非瓣膜性心脏病阵发性房颤的疗效分析. 江西医药, 2013, 48(6):521-523.
11. 刘超群, 席翌智. 胺碘酮联合厄贝沙坦治疗阵发性房颤的疗效及不良反应分析. 现代诊断与治疗, 2013, 24(17):3995-3996.
12. 张春德. 观察胺碘酮联合厄贝沙坦对阵发性房颤的疗效. 心血管病防治知识. 2014, 5(6):54-55.
13. Medi C, Hankey GJ, Freedman SB. Stroke risk and antithrombotic strategies in atrial fibrillation. Stroke, 2010, 41(11):2705-2713.
14. Corradi D. Atrial fibrillation from the pathologist's perspective. Cardiovasc Pathol, 2014, 23(2):71-84.
15. Maan A, Mansour M, McManus DD, et al. Novel therapeutic targets in the management of atrial fibrillation. Am J Cardiovasc Drugs, 2014, 14(6):403-421.
16. 张勇, 杨宝峰. 心房颤动发病机制研究进展. 沈阳药科大学学报, 2011, 28(8): 680-686.
17. Heijman J, Voigt N, Nattel S, et al. Cellular and molecular electrophysiology of atrial fibrillation initiation, maintenance, and progression. Circ Res, 2014, 114(9):1483-1499.
18. Oakes RS, Badger TJ, Kholmovski EG, et al. Detection and quantification of left atrial structural remodeling with delayedenhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation, 2009, 119(13):1758-1767.
19. 苏德兴. 胺碘酮治疗心房颤动复律 124例临床分析. 中国民康医学. 2012, 24(2):161-162.
20. Anand K, Mooss AN, Hee TT, et al. Meta-analysis:inhibition of reninangiotens in system prevents new-onset atrial fibrillation. Am Heart J, 2011, 152(9):217-222.
21. Ji Q, Mei Y, Wang X, et al. Combination of irbesartan and amiodarone to maintain sinus rhythm in patients with persistent atrial fibrillation after rheumatic valve replacement. Circ J, 2010, 74(9):1873-1879.

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Irbesartan combined with Amiodarone versus Amiodarone alone for Paroxysmal Atrial Fibrillation:A Meta-analysis

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