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In Reply: As noted by Dr Santangeli and colleagues, the episodic amiodarone treatment group had significantly larger left atria compared with the continuous amiodarone treatment group. On the other hand, a nonsignificantly greater number of patients in the episodic amiodarone treatment group were using ACE inhibitors, with comparable blood pressure measurements at baseline and history of hypertension. Along with smaller atrial size, the use of ACE inhibitors and angiotensin II receptor blockers are predictors for sinus rhythm maintenance in union with amiodarone therapy.¹ Statins may also play a role in prevention of atrial fibrillation due to pleiotropic effects such as attenuation of inflammation and antioxidant effects.² We are currently conducting a subanalysis to find predictors for the maintenance of sinus rhythm in both treatment groups.

Bleeding complications occurred more often in the episodic amiodarone treatment group. We conducted our study in the Netherlands, and the Dutch guidelines state that for . . . [Full Text of this Article]

Sheba Ahmed, MD
Department of Cardiology
University Medical Center Groningen
University of Groningen
Groningen, the Netherlands

Harry J. G. M. Crijns, MD, PhD
Department of Cardiology
Maastricht University Medical Center
Maastricht, the Netherlands

Isabelle C. Van Gelder, MD, PhD
i.c.van.gelder@thorax.umcg.nl
Department of Cardiology
University Medical Center Groningen
Groningen

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