Abstract Objective：To investigate the clinical effect of losartan combined with amiodarone in patients with paroxysmal atrial fibrillation cardioversion and maintenance of sinus heart rate after cardioversion.Method：From January 2010 to March 2013， 72 patients with nonvalvular paroxysmal atrial fibrillation randomly were given amiodarone therapy
（control group 36 cases） and losartan combined with amiodarone therapy（ observation group 36 cases）， cardioversion of atrial fibrillation was compared after treatment for 24 h，3 d and 7 d. After cardioversion of atrial fibrillation，patients were continued to give drug treatment and followed up for 1 year， the maintenance effect of sinus heart rate was evaluated of the two groups.Result：The atrial fibrillation cardioversion rate in control group after treatment for 24 h，3 d and 7 d was 72.2%（26/36），83.3%（30/36） and 91.7%（33/36），the observation group was 69.4%（25/36），88.9%（32/36）and 97.2%（35/36），the atrial fibrillation cardioversion rate in observation group after treatment for 7 d was significantly increased as compared with the control group（P<0.05）.The maintenance of sinus heart rate in two groups after treatment for 12 months were 69.7%（23/33） and 88.6%（31/35）（P<0.05），and the left atrial diameter in two groups were（38.3±1.9）mm and（ 34.2±2.0）mm（P<0.05）.Conclusion：Application effect of losartan combined with amiodarone in patients with paroxysmal atrial fibrillation cardioversion and maintenance of sinus heart rate after cardioversion are both better than the single use of amiodarone treatment，it may be related to the inhibitory effect of losartan on the renin angiotensin system，reducing the load on the heart，electrical and structural remodeling of atrialrelated inhibition.
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