Randomized Study of Angiotensin II Type 1 Receptor Blocker vs Dihydropiridine Calcium Antagonist for the Treatment of Paroxysmal Atrial Fibrillation in Patients With Hypertension The J-RHYTHM II Study Design for the Investigation of Upstream Therapy for Atrial Fibrillation

Takeshi Yamashita; Satoshi Ogawa; Yoshifusa Aizawa; Hirotsugu Atarashi; Hiroshi Inoue; Tohru Ohe; Ken Okumura; Hiroshi Ohtsu; Takao Kato; Shiro Kamakura; Koichiro Kumagai; Yoshihisa Kurachi; Itsuo Kodama; Yukihiro Koretsune; Tetsunori Saikawa; Masayuki Sakurai; Kaoru Sugi; Haruaki Nakaya; Makoto Hirai; Atsushi Hirayama; Masahiko Fukatani; Hideo Mitamura; Tsutomu Yamazaki; Eiichi Watanabe; The J-RHYTHM II Investigators

doi:10.1253/circj.70.1318

Clinical Investigation

Randomized Study of Angiotensin II Type 1 Receptor Blocker vs Dihydropiridine Calcium Antagonist for the Treatment of Paroxysmal Atrial Fibrillation in Patients With Hypertension

The J-RHYTHM II Study Design for the Investigation of Upstream Therapy for Atrial Fibrillation

Takeshi Yamashita, Satoshi Ogawa, Yoshifusa Aizawa, Hirotsugu Atarashi, Hiroshi Inoue, Tohru Ohe, Ken Okumura, Hiroshi Ohtsu, Takao Kato, Shiro Kamakura, Koichiro Kumagai, Yoshihisa Kurachi, Itsuo Kodama, Yukihiro Koretsune, Tetsunori Saikawa, Masayuki Sakurai, Kaoru Sugi, Haruaki Nakaya, Makoto Hirai, Atsushi Hirayama, Masahiko Fukatani, Hideo Mitamura, Tsutomu Yamazaki, Eiichi Watanabe, The J-RHYTHM II Investigators

Author information

Takeshi Yamashita
Members of the study group are listed in Appendix 1
Satoshi Ogawa
Members of the study group are listed in Appendix 1
Yoshifusa Aizawa
Members of the study group are listed in Appendix 1
Hirotsugu Atarashi
Members of the study group are listed in Appendix 1
Hiroshi Inoue
Members of the study group are listed in Appendix 1
Tohru Ohe
Members of the study group are listed in Appendix 1
Ken Okumura
Members of the study group are listed in Appendix 1
Hiroshi Ohtsu
Members of the study group are listed in Appendix 1
Takao Kato
Members of the study group are listed in Appendix 1
Shiro Kamakura
Members of the study group are listed in Appendix 1
Koichiro Kumagai
Members of the study group are listed in Appendix 1
Yoshihisa Kurachi
Members of the study group are listed in Appendix 1
Itsuo Kodama
Members of the study group are listed in Appendix 1
Yukihiro Koretsune
Members of the study group are listed in Appendix 1
Tetsunori Saikawa
Members of the study group are listed in Appendix 1
Masayuki Sakurai
Members of the study group are listed in Appendix 1
Kaoru Sugi
Members of the study group are listed in Appendix 1
Haruaki Nakaya
Members of the study group are listed in Appendix 1
Makoto Hirai
Members of the study group are listed in Appendix 1
Atsushi Hirayama
Members of the study group are listed in Appendix 1
Masahiko Fukatani
Members of the study group are listed in Appendix 1
Hideo Mitamura
Members of the study group are listed in Appendix 1
Tsutomu Yamazaki
Members of the study group are listed in Appendix 1
Eiichi Watanabe
Members of the study group are listed in Appendix 1
The J-RHYTHM II Investigators

Keywords: Atrial fibrillation, Randomized control study, Renin - angiotensin system

JOURNAL FREE ACCESS

2006 Volume 70 Issue 10 Pages 1318-1321

DOI https://doi.org/10.1253/circj.70.1318

Details

Abstract

Background Mega trials of rhythm vs rate control could not demonstrate the usefulness of available antiarrhythmic drugs, so a more effective and safer therapy for atrial fibrillation (AF) is now required. One candidate is the so-called "upstream therapy", which refers to the blockade of upstream modifying elements (renin - angiotensin system, cathecholamines, oxidative stress etc) that contribute to the arrhythmogenic substrate. Methods and Results The Japanese Rhythm Management Trial II for Atrial Fibrillation (J-RHYTHM II study) is a randomized comparative evaluation of an angiotensin II type 1 blocker (candesartan) and a dihydropiridine calcium blocker (amlodipine), both combined with antithrombotic therapy, as an antiarrhythmic therapy for the treatment of paroxysmal AF (PAF) associated with hypertension. To test the usefulness of this therapy, this study will reveal the recurrence rate of asymptomatic as well as symptomatic PAF during 1-year of treatment with candesartan or amlodipine, using daily transtelephonic monitoring. Conclusions The J-RHYTHM II study will follow 400 patients with PAF and hypertension who were treated at approximately 50 sites throughout Japan, and will provide clinically important information. (Circ J 2006; 70: 1318 - 1321)

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