No role for ARB in AF without structural heart disease:
Angiotensin II-Antagonist in Paroxysmal Atrial Fibrillation (ANTIPAF)-Trial [Circ Arrhythm Electrophysiol. 2012 Feb;5(1):43-51] evaluated the role of angiotensin II receptor blockade (ARB) in paroxysmal atrial fibrillation (AF) in the absence of structural heart disease. It is well known that unlike antiarrhythmic agents, ARBs are safe in those with structural heart disease and they also have a role in prevention of atrial fibrillation in this setting. NTIPAF trial investigated the role of olmesartan medoxomil in reducing the burden of atrial fibrillation in patients with paroxysmal AF without structural heart disease. It was a placebo controlled, prospective, randomized, multicentric trial. They concluded that one year treatment angiotensin receptor blockers in patients with paroxysmal AF and no structural heart disease did not reduce the burden of atrial fibrillation. Only time to prescription of the recovery medication (amiodarone) was earlier in the placebo group (p=0.022).