Propafenone and lisinopril therapy effectiveness for sinus rhythm maintenance in patients with persistent atrial fibrillation and arterial hypertension (PROMETEY-III)

Abstract

Aim. To study effectiveness and safety of combined propafenone and lisinopril therapy for sinus rhythm (SR) maintenance in patients with persistent atrial fibrillation (AF) and arterial hypertension (AH).
Material and methods. The study included 134 patients with persistent AF ad AH (age 41-62 years; mean age 52,8 ±3,2 years) from 4 Russian regions. To prevent AF paroxysms, all participants received propafenone (450 mg/d, 3 times per day) and lisinopril (5-10 mg/d). The control group included 71 individuals (mean age 52,1±5,6 years) with persistent AF ad AH, who received propafenone monotherapy (450 mg/d per os).
Results. After 3 months of propafenone and lisinopril therapy, SR was maintained in 114 (85%) patients and 53 (75%) controls, after 12 months of the treatment in 80 (60%) and 32 (45%), respectively. According to echocar diography data, left atrium (LA) anterior posterior size significantly decreased after 12 months of propafenone and lisinopril therapy: from 44,3±3 to 33,4±2 mm (p<0,05). According to 24-hour blood pressure (BP) monitoring results, after 3 months of the treatment, systolic and diastolic BP levels significantly decreased: from 168±10,8 to 130±8,6 mm Hg and from 118±8,7 to 86±5,3 mm Hg, respectively (р<0,05). Target BP levels were observed throughout the whole therapy period.
Conclusion. Propafenone and lisinopril therapy is an effective method of AF paroxysm prevention in patients with persistent AF and AH. Early lisinopril administration is associated with LA size decrease and target BP level achievement.