ACE and chronic kidney disease: This observation is strengthened by findings of inflammatory changes in cardiac biopsy specimens from patients with AF.17 Furthermore, structural abnormalities, such as increasing left atrial diameter and left ventricular hypertrophy related to CKD, have been associated with increased risk of incident AF.17 L'Allier et al18 reported decreased incident AF among 10 926 hypertensive patients treated with angiotensin-converting enzyme inhibitors versus calcium channel blockers.