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Moxonidine may curb AF in hypertensive patients

NEW YORK (Reuters Health) – In hypertensive patients with paroxysmal atrial fibrillation (AF), moxonidine appeared beneficial in a small pilot study from Greece.

The main aim of the study, according to Dr. Georgios Giannopoulos, “was to probe the potential of central sympathetic nervous system inhibition by moxonidine to reduce AF burden.”

Moxonidine is widely used for treating hypertension, but it’s not approved in the U.S.

In a randomized crossover trial reported online May 31 in the American Journal of Cardiology, Dr. Giannopoulos of Athens General Hospital “G. Gennimatas” and colleagues studied 56 patients. Placebo or moxonidine was given for a six-week period followed a two-week washout period and then another six-week treatment course.

The AF burden was 28.0 minutes per day during placebo treatment vs. 16.5 minutes per day with moxonidine (p<0.01). Similarly, European Heart Rhythm Association symptom severity class was lower on active treatment (1.0 vs. 2.0, p<0.01). There was also a significant drop in diastolic blood pressure, although systolic pressures were similar.

There were no serious adverse events and the most common side effect was dry mouth (28.6%).

“The main focus of our research is improving post-AF-ablation results and, based on the results of this small study, we have initiated a larger study… which will test moxonidine efficacy in reducing post-ablation AF recurrences,” Dr. Giannopoulos said.

Still, he added, “the results of the present study can also stand on their own, since they do demonstrate the usefulness of this drug in hypertensive patients with frequent AF episodes and this is something the clinician can have in mind when making treatment choices for such patients.”

The larger study aims to enroll 150 patients and results are expected in 2014.

The researchers say they have no conflicts of interest to disclose.


Am J Cardiol 2013.