Pan CT, Liao CW, Tsai CH, et al. - Since there is a lack of clarity regarding the effect of target treatment to avert new-onset atrial fibrillation (NOAF), researchers assessed NOAF incidence under different treatment strategies in patients suffering from primary aldosteronism (PA). They utilized the National Health Insurance Research Database in Taiwan to extract longitudinal data for patients with PA without atrial fibrillation history from 1997 to 2009. Controls were patients having essential hypertension matched by propensity score. Overall 2,202 patients with PA, including 534 treated with adrenalectomy and 1,668 with mineralocorticoid receptor antagonist [MRA] therapy, as well as 8,808 essential hypertension controls were included. The mean follow-up was 4.4 years. Findings revealed a lower incidence of NOAF in patients with PA who had adrenalectomy vs patients with essential hypertension. However, this was not seen in those with PA who took MRA therapy with a lower dose. Experts noted that differences between the 2 strategies may decrease with a higher dose of MRA therapy.