Objective To observe the influences of valsartan on maintenance of sinus rhythm and left atrial contraction function after cardioversion of permanent atrial fibrillation, and discuss if angiotensin Ⅱ (AT-Ⅱ)receptor blockade could reverse atrial remodeling and remove the basis of permanent atrial fibrillation relapse. Methods Seventy-two patients with permanent atrial fibrillation were divided into control group (36 patients)and valsartan group(36 patients)by random digits table. The two groups were given amiodarone of 200 mg oral once every 8 hours on the eardioversion day. Five days later, the dose was decreased to 200 mg once every 12 hours. And another 5 days later, the dose was again decreased to 200 mg once a day. And 1 month later, the dose was decreased to 100 mg once a day which would be kept for 8 months. On the electrical conversion day and after 8 months, the patients of the two groups were performed echocardiography, and the left atrial dimension(LAD), end diastolic area(EDA), end diastolic volume (EDV), end systolic area(ESA)and end systolic volume(ESV)were compared. Results In 72 patients,59 patients were successful in recovering from sinus rhythm, and duration time was(18±6)h,3 patients were given electrical conversion after 72 h, and 10 patients were directly given electrical conversion and successful. Three patients didn't finish follow-up,and 2 patients died. Sixty-seven patients finished follow-up,among whom 33 patients were in control group and 34 patients were in valsartan group. After followed up for 8 months, 36.4%(12/33)patients recurred in control group, and 17.6%(6/34)patients recurred in valsartan group(P＜0.05).The levels of LAD, EDA, ESA, EDV and ESV in valsartan group were significantly decreased(P＜0.05 or＜0.01), but they showed no significantly difference in control group(P ＞ 0.05). The systolic pressure and diastolic pressure decreased in two groups, but there were no significant difference (P＞0.05). Conclusion Valsartan combines with amiodarone is superior to amiodarone in maintaining sinus rhythm and improving left atrial contraction function after cardioversion of permanent atrial fibrillation.