@article{3158643,
    title = "Effectiveness of Moxonidine to Reduce Atrial Fibrillation Burden in
Hypertensive Patients",
    author = "Deftereos, Spyridon and Giannopoulos, Georgios and Kossyvakis, and Charalampos and Efremidis, Michael and Panagopoulou, Vasiliki and and Raisakis, Konstantinos and Kaoukis, Andreas and Karageorgiou, Sofia and and Bouras, Georgios and Katsivas, Apostolos and Pyrgakis, Vlasios and and Stefanadis, Christodoulos",
    journal = "AMERICAN JOURNAL OF CARDIOLOGY",
    year = "2013",
    volume = "112",
    number = "5",
    pages = "684-687",
    publisher = "EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC",
    issn = "0002-9149",
    doi = "10.1016/j.amjcard.2013.04.049",
    abstract = "There is substantial evidence that the autonomic system plays an
important part in the pathogenesis of atrial fibrillation (AF). It
appears that, although some patients have a preponderantly sympathetic
or vagal overactivation leading to AF, a combined sympathovagal drive is
most commonly responsible for AF triggering. The purpose of this
hypothesis-generating study was to test whether moxonidine, a centrally
acting sympathoinhibitory agent, on top of optimal antihypertensive
treatment, can lead to a decrease in AF burden in hypertensive patients
with paroxysmal AF. This was a prospective, double-blind, 1-group,
crossover study. Hypertensive patients with paroxysmal AF sequentially
received treatment with placebo and moxonidine for two 6-week periods,
respectively. The change in AF burden (measured as minutes of AF per day
in three 48-hour Holter recordings) between the 2 treatment periods was
the primary outcome measure. Fifty-six patients (median age 63.5 years,
35 men) were included. During moxonidine treatment, AF burden was
reduced from 28.0 min/day (interquartile range [IQR] 15.0 to 57.8) to
16.5 min/day (IQR 4.0 to 36.3; p <0.01). European Heart Rhythm
Association symptom severity class decreased from a median of 2.0 (IQR
1.0 to 2.0) to 1.0 (IQR 1.0 to 2.0; p = 0.01). Systolic blood pressure
levels were similar in the 2 treatment periods, whereas diastolic blood
pressure was lower (p <0.01) during moxonidine treatment. The most
frequent complaint was dry mouth (28.6%). No serious adverse events
were recorded. In conclusion, treatment with moxonidine, a centrally
acting sympathoinhibitory agent, results in reduction of AF burden and
alleviation of AF-related symptoms in hypertensive patients with
paroxysmal AF. (C) 2013 Elsevier Inc. All rights reserved."
}