A randomized controlled clinical trial to investigate the efficacy of Olmesartane (Angiotensin II receptor blocker) to prevent paroxysmal atrial fibrillation
Prof. Andreas Goette, Paderborn, Germany
Atrial Fibrillation NETwork (AFNET), Münster, Germany
German Federal Ministry of Education and Research
ANTIPAF - AFNET 2 is the first study to prospectively test the hypothesis that the angiotensin II receptor blocker olmesartan suppresses episodes of paroxysmal atrial fibrillation.
The study hypothesis couldn't be proven. The study didn't show a significant difference between olmesartan and placebo in terms of atrial fibrillation burden. However, the time to prescription of amiodarone was longer in patients treated with olmesartan than in those who received placebo. In patients with atrial fibrillation and an additional structural heart disease such as high blood pressure or systolic heart failure, angiotensin II receptor blockers are an effective adjunctive therapy. ANTIPAF – AFNET 2 clearly shows that these substances are not suitable for preventing paroxysmal atrial fibrillation in patients without structural heart disease.
Goette A, Schön N, Kirchhof P, Breithardt G, Fetsch T, Häusler KG, Klein HU, Steinbeck G, Wegscheider K, Meinertz T. Angiotensin II-Antagonist in Paroxysmal Atrial Fibrillation (ANTIPAF)-Trial. Circ Arrhythm Electrophysiol. 2012; 5;43-51. DOI:10.1161/CIRCEP.111.965178
von Eisenhart Rothe A, Bielitzer M, Meinertz T, Limbourg T, Ladwig KH, Goette A. Predictors of discordance between physicians' and patients' appraisals of health-related quality of life in atrial fibrillation patients: Findings from the Angiotensin II Antagonist in Paroxysmal Atrial Fibrillation Trial. Am Heart J. 2013 Sep;166(3):589-596.e1. doi: 10.1016/j.ahj.2013.05.020.
Okutucu S, Katircioglu-Öztürk D, Oto E, Güvenir HA, Karaagaoglu E, Oto A, Meinertz T, Goette A. Data mining experiments on the Angiotensin II-Antagonist in Paroxysmal Atrial Fibrillation (ANTIPAF-AFNET 2) trial: 'exposing the invisible'. Europace. 2017 May 1; 19 (5):741 - 746. pii: euw084. doi: 10.1093/europace/euw084 . Epub 2016 Oct 11.