TY - JOUR
TI - Effectiveness of Moxonidine to Reduce Atrial Fibrillation Burden in
Hypertensive Patients
AU - Deftereos, Spyridon
AU - Giannopoulos, Georgios
AU - Kossyvakis,
AU - Charalampos
AU - Efremidis, Michael
AU - Panagopoulou, Vasiliki and
AU - Raisakis, Konstantinos
AU - Kaoukis, Andreas
AU - Karageorgiou, Sofia and
AU - Bouras, Georgios
AU - Katsivas, Apostolos
AU - Pyrgakis, Vlasios and
AU - Stefanadis, Christodoulos
JO - AMERICAN JOURNAL OF CARDIOLOGY
PY - 2013
VL - 112
TODO - 5
SP - 684-687
PB - EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
SN - 0002-9149
TODO - 10.1016/j.amjcard.2013.04.049
TODO - null
TODO - 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.
ER -