Vol 19, No 3 (2012)
Review Article
Published online: 2012-05-28
Antiarrhythmic potential of aldosterone antagonists in atrial fibrillation
Cardiol J 2012;19(3):223-229.
Abstract
Upstream therapy is the promising issue in the treatment of atrial fibrillation (AF) especially
in patients with arterial hypertension and heart failure. The possible beneficial effects of renin–
–angiotensin–aldosterone system blockade with ACE-inhibitors and angiotensin receptor antagonists
in AF prevention have been demonstrated in experimental and clinical studies.
There is growing mass of evidence, from both theoretical and experimental research studies, to
suggest that upstream therapy using spironolactone or eplerenone may reduce the deleterious
effect of excess aldosterone secretion and further modify the environment of AF including
inhibition of atrial muscle fibrosis. It refers to patients with different forms of AF, including
chronic AF. Aldosterone antagonists treatment may be a simple and valuable additional
option in low-risk, hypertensive and heart failure patients in primary and secondary prevention
of refractory paroxysmal and persistent AF.
Keywords: aldosterone antagonistsatrial fibrillation
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