Atorvastatin prevents atrial fibrillation in patients with bradyarrhythmias and implantation of an atrial-based or dual-chamber pacemaker: A prospective randomized trial

Chia Ti Tsai, Ling Ping Lai, Juey Jen Hwang, Yi Chih Wang, Fu Tien Chiang, Jiunn Lee Lin

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Abstract

Background: Increasing evidence suggests that atrial fibrillation (AF) is an inflammatory disease. Statins is an anti-inflammatory agent. The present study was conducted to test the efficacy of atorvastatin in preventing paroxysmal AF or atrial high rate episodes (AHEs) in patients with bradyarrhythmias and implantation of an atrial-based or dual-chamber pacemaker. Methods: The effect of atorvastatin on time to the first attack of AF or AHE (≥180 per minute and ≥1 or 10 minutes), which was accurately detected by pacemaker interrogation, was evaluated in an open-label prospective randomized design for 1 year of follow-up. Results: Fifty-two patients (23 males, 70 ± 13 years old) were randomized to the statin group (atorvastatin 20 mg/d) and 54 (25 males, 72 ± 13 years old) to the nonstatin group. Event-free survivals from AHE ≥1 minute were not significantly different between the 2 groups (log-rank P = .410). However, patients in the nonstatin group were more likely to develop AHE ≥10 minutes than those in the statin group (log-rank P = .028). Atrial high rate episode ≥10 minutes occurred in 3 (5.8%) of 51 patients in the statin group after 1 year of follow-up, and 10 (19.2%) of 52 patients (odds ratio 0.26, P = .041) in the nonstatin group. The mean left atrial volume of the statin group was significantly lower than that of the nonstatin group at the end of follow-up (39.7 ± 1.7 vs 43.7 ± 1.9 mL, P < .0001). Conclusions: The present study demonstrated the efficacy of atorvastatin in preventing significant AF (≥10 minutes) and left atrial enlargement in patients with bradyarrhythmias and implantation of a pacemaker.

Original languageEnglish
Pages (from-to)65-70
Number of pages6
JournalAmerican Heart Journal
Volume156
Issue number1
DOIs
Publication statusPublished - Jul 1 2008
Externally publishedYes

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Bradycardia
Atrial Fibrillation
Disease-Free Survival
Atorvastatin Calcium
Anti-Inflammatory Agents
Odds Ratio

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Atorvastatin prevents atrial fibrillation in patients with bradyarrhythmias and implantation of an atrial-based or dual-chamber pacemaker : A prospective randomized trial. / Tsai, Chia Ti; Lai, Ling Ping; Hwang, Juey Jen; Wang, Yi Chih; Chiang, Fu Tien; Lin, Jiunn Lee.

In: American Heart Journal, Vol. 156, No. 1, 01.07.2008, p. 65-70.

Research output: Contribution to journalArticle

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abstract = "Background: Increasing evidence suggests that atrial fibrillation (AF) is an inflammatory disease. Statins is an anti-inflammatory agent. The present study was conducted to test the efficacy of atorvastatin in preventing paroxysmal AF or atrial high rate episodes (AHEs) in patients with bradyarrhythmias and implantation of an atrial-based or dual-chamber pacemaker. Methods: The effect of atorvastatin on time to the first attack of AF or AHE (≥180 per minute and ≥1 or 10 minutes), which was accurately detected by pacemaker interrogation, was evaluated in an open-label prospective randomized design for 1 year of follow-up. Results: Fifty-two patients (23 males, 70 ± 13 years old) were randomized to the statin group (atorvastatin 20 mg/d) and 54 (25 males, 72 ± 13 years old) to the nonstatin group. Event-free survivals from AHE ≥1 minute were not significantly different between the 2 groups (log-rank P = .410). However, patients in the nonstatin group were more likely to develop AHE ≥10 minutes than those in the statin group (log-rank P = .028). Atrial high rate episode ≥10 minutes occurred in 3 (5.8{\%}) of 51 patients in the statin group after 1 year of follow-up, and 10 (19.2{\%}) of 52 patients (odds ratio 0.26, P = .041) in the nonstatin group. The mean left atrial volume of the statin group was significantly lower than that of the nonstatin group at the end of follow-up (39.7 ± 1.7 vs 43.7 ± 1.9 mL, P < .0001). Conclusions: The present study demonstrated the efficacy of atorvastatin in preventing significant AF (≥10 minutes) and left atrial enlargement in patients with bradyarrhythmias and implantation of a pacemaker.",
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T1 - Atorvastatin prevents atrial fibrillation in patients with bradyarrhythmias and implantation of an atrial-based or dual-chamber pacemaker

T2 - A prospective randomized trial

AU - Tsai, Chia Ti

AU - Lai, Ling Ping

AU - Hwang, Juey Jen

AU - Wang, Yi Chih

AU - Chiang, Fu Tien

AU - Lin, Jiunn Lee

PY - 2008/7/1

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N2 - Background: Increasing evidence suggests that atrial fibrillation (AF) is an inflammatory disease. Statins is an anti-inflammatory agent. The present study was conducted to test the efficacy of atorvastatin in preventing paroxysmal AF or atrial high rate episodes (AHEs) in patients with bradyarrhythmias and implantation of an atrial-based or dual-chamber pacemaker. Methods: The effect of atorvastatin on time to the first attack of AF or AHE (≥180 per minute and ≥1 or 10 minutes), which was accurately detected by pacemaker interrogation, was evaluated in an open-label prospective randomized design for 1 year of follow-up. Results: Fifty-two patients (23 males, 70 ± 13 years old) were randomized to the statin group (atorvastatin 20 mg/d) and 54 (25 males, 72 ± 13 years old) to the nonstatin group. Event-free survivals from AHE ≥1 minute were not significantly different between the 2 groups (log-rank P = .410). However, patients in the nonstatin group were more likely to develop AHE ≥10 minutes than those in the statin group (log-rank P = .028). Atrial high rate episode ≥10 minutes occurred in 3 (5.8%) of 51 patients in the statin group after 1 year of follow-up, and 10 (19.2%) of 52 patients (odds ratio 0.26, P = .041) in the nonstatin group. The mean left atrial volume of the statin group was significantly lower than that of the nonstatin group at the end of follow-up (39.7 ± 1.7 vs 43.7 ± 1.9 mL, P < .0001). Conclusions: The present study demonstrated the efficacy of atorvastatin in preventing significant AF (≥10 minutes) and left atrial enlargement in patients with bradyarrhythmias and implantation of a pacemaker.

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