Long-term Efficacy of Combination Therapy with Anti-arrhythmic Agents and Pravastatin in Patients with Paroxysmal Atrial Fibrillation

Objective: To investigate the long-term effects of combination therapy with antiarrhythmic agents and pravastatin (10 mg/day) in maintaining sinus rhythm in patients with paroxysmal atrial fibrillation (AF) and hyperlipidemia.Method and Results: In all, 318 patients (mean age: 69 ± 12 years) with paroxysmal AF were divided into 2 groups, one receiving pravastatin for hyperlipidemia (pravastatin (+) group, N = 41) and the other not (pravastatin (−) group, N = 277). At 60 months, the survival rate for patients free from conversion to permanent AF was significantly greater in the pravastatin (+) group than in the pravastatin (−) group. The percentage of patients who eventually developed permanent AF despite anti-arrhythmic therapy was significantly lower in the pravastatin (+) group than in the pravastatin (−) group (9.8% vs. 25.3%). Left atrial dimensions were significantly increased in the pravastatin (−) group during the follow-up period (from 34.8 ± 6.6 mm to 37.6 ± 7.0 mm: p < 0.01). In contrast, in the pravastatin (+) group, left atrial dimensions remained unchanged between baseline and after treatment (34.4 ± 7.3 mm vs 35.5 ± 6.6 mm).Conclusion: In patients with paroxysmal AF and hyperlipidemia, addition of pravastatin to anti-arrhythmic agents seems to enhance the efficacy of these agents in maintaining sinus rhythm and preventing the development of structural remodeling in the myocardium.