Kardiologie up2date 2011; 7(2): 102-108
DOI: 10.1055/s-0030-1256535
Hotline – Herzrhythmusstörungen

© Georg Thieme Verlag KG Stuttgart · New York

Upstream-Therapie bei Vorhofflimmern

Andreas  Goette
Further Information

Publication History

Publication Date:
21 July 2011 (online)


In the recent years a tremendous amount has been learned about the pathophysiology of atrial fibrillation (AF). AF induces substantial electrophysiological changes in the atrium causing electrical as well as structural changes named remodelling. Besides calcium-dependant tissue alterations, which are induced by activation of proteases and phosphatases like calpain and calciurin concomitant cardiac diseases like hypertension, heart failure and valve diseases have been demonstrated to activate the atrial angiotensin II-system. Angiotensin-II has been shown to induce progressive proarrhythmic atrial fibrosis. Initially, experimental studies suggested that therapy with angiotensin II-receptor blockers can reduce the amount of proarrhythmic fibrosis. Clinical studies, however, have provided mixed results. Especially in the last year multiple studies have been shown that the use of angiotensin II-receptor blockers does not influence the recurrence of AF. Preliminary results of the ANTIPAF trial show that a therapy with an ARB does not influence the overall burden of AF using transtelephonic ECG-monitoring.


Prof. Dr. med. Andreas Goette

Chefarzt der Medizinischen Klinik II
St. Vincenz-Krankenhaus Paderborn GmbH

Am Busdorf 2
33098 Paderborn

Email: [email protected]