Some clinical studies have suggested that treatment with angiotensin receptor blockers like valsartan (Diovan®) may prevent AF. This study recruited 1,442 patients in sinus rhythm who had two or more episodes of AF in the previous 6 months or who had been successfully undergone cardioversion in the previous 2 weeks. Participants also had existing morbidities of cardiovascular disease, diabetes or left atrial enlargement.
Participants were randomly assigned to treatment with placebo or valsartan and followed up for 1 year. Data were collected based on time to first recurrence of AF and proportion of patients in whom AF recurred within follow up.
AF recurred in 51.4% of the active treatment arm and in 52.1% of the placebo arm. This difference was not statistically significant (p=0.73) and there was also no difference in the time to recurrence. The authors conclude that, "valsartan was not associated with a reduction in the incidence of recurrent atrial fibrillation".
Action: Clinicians should ensure that treatment choices in AF are based on current evidence; valsartan should not be used to prevent recurrence of AF.