Innovativer Therapieansatz bei Vorhofflimmern: AT₁-Rezeptorblockade

Zusammenfassung

Anhaltspunkte, dass die Hemmung des Renin-Angiotensin-Systems einen Schutz vor Vorhofflimmern bietet, ergeben sich aus Post-hoc-Analysen von Therapiestudien bei Patienten mit Hypertonie/Linksherzhypertrophie, Herzinsuffizienz oder stattgehabtem Myokardinfarkt. Darüber hinaus lassen prospektive Untersuchungen erkennen, dass bei Patienten mit bereits manifestem Vorhofflimmern nach erfolgreicher Kardioversion die Komedikation mit ACE-Hemmern oder AT₁-Rezeptorantagonisten den Erfolg einer antiarrhythmischen Rezidivprophylaxe unterstützt. Der allem Anschein nach vorhandene antiarrhythmische/antifibrillatorische Effekt dieser Substanzen beruht wahrscheinlich darauf, dass sie zur Regression des unter Mitwirkung von Angiotensin II entstandenen elektrischen, strukturellen und endokardialen Remodelings beitragen.

Summary

Retrospective analysis of trials in patients with hypertension/left heart hypertrophy or previous myocardial infarction has suggested that inhibition of the renin-angiotensin system provides protection against atrial fibrillation (AF). Furthermore, prospective trials have given indication that, in patients with manifest AF after previous successful cardioversion, the addition of ACE inhibitors or AT₁ receptor antagonists support successful anti-arrhythmic protection against recurrent AF. The apparent anti-arrhythmic/rhythmic/antifibrillatory efficacy of this latter substance probably results from its contribution to the regression of angiotensin II-aided electrical, structural and endocardial remodelling.

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