Efficacy of Perindopril to Prevent Recurrence of Atrial Fibrillation in Patients With Essential Hypertension

• Patients must be age 18 years or older.
• Patients may be either male or female without childbearing potential (or with adequate contraception).
• Patients must have a current diagnosis of essential hypertension with systolic blood pressure (SBP) ≤ 160 mmHg and diastolic blood pressure (DBP) ≤ 100 mmHg at the time of inclusion visit AND

• Patients must have had at least one episode of symptomatic paroxysmal or persistent atrial fibrillation within the preceding six months:

  • With an indication for cardioversion in the case of persistent AF
  • With electrocardiogram (ECG) documentation of AF
  • With duration of an AF episode of at least 10 minutes

Exclusion Criteria:

• Unlikely to co-operate in the study
• Pregnancy, breastfeeding, or possibility of becoming pregnant during the study (patients must have adequate contraception as determined by the investigator).
• Alcoholism or drug abuse
• Participation in another study at the same time or within 30 days of randomisation.
• Left ventricular systolic dysfunction with an ejection fraction of 45% or less
• Myocardial infarction within the past month prior to the selection visit
• Cardiac or thoracic surgery within the past 3 months or likely to be performed during the trial
• Chronic AF (continuously present for > 6 months)
• AF secondary to an acute reversible condition (e.g. post-operative atrial fibrillation, hyperthyroidism)
• Currently requiring class I or class III anti-arrhythmic drug therapy (for atrial fibrillation or any other arrhythmia)
• Any medical condition that makes the patient an unsuitable candidate in the investigator's opinion
• Any medical condition requiring ACE inhibitor or angiotensin-receptor blocker therapy (e.g. diabetes, known proteinuria of more than 300 mg per day)
• Renal insufficiency with serum creatinine of 180 μmol/L or greater
• Known bilateral renal artery stenosis
• Serum potassium of 5.0 mmol/L or greater on recent laboratory exam
• Positive pregnancy test (beta human chorionic gonadotropin [HCG] performed in women of childbearing potential)
• Known intolerance to ACE inhibitor
• Impossibility to discontinue certain treatments at selection visit
• Known contraindication(s) to perindopril
• Severe known liver disease including cirrhosis, biliary obstruction or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) elevation more than 3 times the upper limit of normal
• Use of ACE inhibitor or angiotensin-receptor blocker in the 3 months before the inclusion visit
• Severely uncontrolled hypertension with SBP > 160 mmHg or DBP > 100 mmHg at the inclusion visit.