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

1.	梁珍玲, 孫葉海, 彭衛平. 厄貝沙坦聯合胺碘酮治療陣發性心房顫動的療效. 中國老年學雜志, 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.	廖偉, 陽貽紅, 嚴章林, 等. 厄貝沙坦聯合胺碘酮治療非瓣膜病陣發性心房顫動療效觀察. 山東醫藥, 2008, 48(7):66-67.
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6.	石新國, 李霞, 張華. 胺碘酮與厄貝沙坦聯合治療陣發性房顫的臨床觀察. 新疆醫學, 2010, 40(5):38-40.
7.	李超, 蔣勇, 韋玉華. 胺碘酮聯合厄貝沙坦治療陣發性房顫的臨床觀察. 柳州醫學, 2011, 24(2):79-81.
8.	徐愛琴. 胺碘酮聯合厄貝沙坦治療陣發性心房顫動療效觀察. 2011, 15(11):1421-1422.
9.	冼飛, 潘俊泰. 胺碘酮聯合厄貝沙坦治療陣發性心房顫動療效觀察. 2011, 18(12):1894-1895.
10.	劉國偉, 周菊洪. 胺碘酮聯合厄貝沙坦治療非瓣膜性心臟病陣發性房顫的療效分析. 江西醫藥, 2013, 48(6):521-523.
11.	劉超群, 席翌智. 胺碘酮聯合厄貝沙坦治療陣發性房顫的療效及不良反應分析. 現代診斷與治療, 2013, 24(17):3995-3996.
12.	張春德. 觀察胺碘酮聯合厄貝沙坦對陣發性房顫的療效. 心血管病防治知識. 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.	張勇, 楊寶峰. 心房顫動發病機制研究進展. 沈陽藥科大學學報, 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.	蘇德興. 胺碘酮治療心房顫動復律 124例臨床分析. 中國民康醫學. 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, 孫葉海, 彭衛平. 厄貝沙坦聯合胺碘酮治療陣發性心房顫動的療效. 中國老年學雜志, 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. 廖偉, 陽貽紅, 嚴章林, 等. 厄貝沙坦聯合胺碘酮治療非瓣膜病陣發性心房顫動療效觀察. 山東醫藥, 2008, 48(7):66-67.
5. 邵明, 華晶. 厄貝沙坦聯合胺碘酮治療陣發性心房顫動的臨床研究. 現代實用醫學, 2009, 21(7):751-752.
6. 石新國, 李霞, 張華. 胺碘酮與厄貝沙坦聯合治療陣發性房顫的臨床觀察. 新疆醫學, 2010, 40(5):38-40.
7. 李超, 蔣勇, 韋玉華. 胺碘酮聯合厄貝沙坦治療陣發性房顫的臨床觀察. 柳州醫學, 2011, 24(2):79-81.
8. 徐愛琴. 胺碘酮聯合厄貝沙坦治療陣發性心房顫動療效觀察. 2011, 15(11):1421-1422.
9. 冼飛, 潘俊泰. 胺碘酮聯合厄貝沙坦治療陣發性心房顫動療效觀察. 2011, 18(12):1894-1895.
10. 劉國偉, 周菊洪. 胺碘酮聯合厄貝沙坦治療非瓣膜性心臟病陣發性房顫的療效分析. 江西醫藥, 2013, 48(6):521-523.
11. 劉超群, 席翌智. 胺碘酮聯合厄貝沙坦治療陣發性房顫的療效及不良反應分析. 現代診斷與治療, 2013, 24(17):3995-3996.
12. 張春德. 觀察胺碘酮聯合厄貝沙坦對陣發性房顫的療效. 心血管病防治知識. 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. 張勇, 楊寶峰. 心房顫動發病機制研究進展. 沈陽藥科大學學報, 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. 蘇德興. 胺碘酮治療心房顫動復律 124例臨床分析. 中國民康醫學. 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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