Atriyum fibrilasyonu olup DCS ile sinüs ritmine dönen olgularda ramipril doz titrasyonunun nükse etkisi

SAVAŞ BEYAZTAŞ

Atriyum fibrilasyonu olup DCS ile sinüs ritmine dönen olgularda ramipril doz titrasyonunun nükse etkisi

Tezin Türü: Tıpta Uzmanlık

Tezin Yürütüldüğü Kurum: Eskişehir Osmangazi Üniversitesi, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, Türkiye

Tezin Onay Tarihi: 2007

Tezin Dili: Türkçe

Öğrenci: SAVAŞ BEYAZTAŞ

Danışman: BÜLENT GÖRENEK

Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu

Özet:

ABSTRACTBeyaztas,S. The effect of ramipril dose titration on recurrence in patients withAF who had sinus rhythm after DCS. Eskişehir Osmangazi University Facultyof Medicine, Medical Specialty Thesis in Department of Cardiology, Eskisehir2007. 134 patients (85 female, 49 male, mean age 65.8 Â± 5.3, 68.8 Â± 9.6,respectively) who had chronic AF and planned to convert to sinus rhythm (SR) wereincluded to study. Recurrence of AF remains as an important problem aftersuccessful cardioversion. There are benefit outcomes of using angiotensin convertingenzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) in patients whohave restorated to SR in the last years. As a result of limited studies, the success ofcardioversion increases and recurrence decreases. But there are no knowledge aboutdifference between different doses of ACE inhibitors and ARB. This is the firststudy in this subject. Amiodarone therapy was used for all cases ten days beforecardioversion and after this period oral amiodarone 200 mg daily were continued. Inaddition, two groups formed from 134 cases four weeks before cardioversion:Ramipril 2.5 mg/day (69 cases) and 10 mg/day (65 cases). All patients underwentelectrical cardioversion. Restoration of sinus rhythm wasn't obtained in 7 cases. AFrecuurence developed in 47 cases after successful cardioversion. The maintanence ofSR rate was %63.9 in cases who given 2.5 mg ramipril daily and %56.9 in cases whogiven 10 mg ramipril daily, there is no significant difference between two groups (p< 0.05). As a result, we concluded that low dose of ACE inhibitor is enough toreduce AF recurrence, the higher dose of ACE inhibitors has not addition benefit.Key words: AF recurrence, ramipril, cardioversion.