MedWire News: Atorvastatin treatment does not significantly improve the percentage of persistent atrial fibrillation (AF) patients who maintain sinus rhythm (SR) following electrical cardioversion, report researchers in the European Heart Journal.
“The high relapse rate after cardioversion of persistent AF represents a clinical challenge,” comment Henrik Almroth (Örebro University Hospital, Sweden) and co-investigators. “The percentage of patients in SR is approximately 30% 6 months after a cardioversion without the use of prophylactic anti-arrhythmic treatment.”
Some previous studies have demonstrated an anti-arrhythmic effect for lipid-lowering drugs such as statins, but others have been less conclusive.
“Possible mechanisms behind the anti-arrhythmic effect of statins are unclear, but it has been suggested that their anti-inflammatory properties may play a role,” say the researchers.
In this study, the team randomly assigned 234 AF patients, aged 65 years on average, to treatment with atorvastatin 80 mg/day (n=118) or placebo (n=116) in a double-blind fashion. Participants began treatment 14 days prior to electrical cardioversion for correction of AF and continued for a further 30 days afterwards.
At electrical cardioversion, 89% and 86% patients converted to SR in the atorvastatin-treated and placebo groups, respectively. At study completion (30 days) the corresponding values were considerably lower, at 51% and 42%, displaying a nonsignificant difference between the two groups.
“The results suggest that the potential benefit from statin therapy in terms of electrophysiologic effects was less than expected since atorvastatin treatment did not come out statistically superior to placebo with regards to maintaining SR 30 days after cardioversion,” conclude Almroth et al.
They add: “These results do not support the use of this agent as an alternative to traditional anti-arrhythmic treatment in the cohort studied.”
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