ORIGINAL ARTICLE   

Minerva Cardioangiologica 2020 June;68(3):224-33

DOI: 10.23736/S0026-4725.20.05116-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Investigation of proper home blood pressure with atrial fibrillation recurrence in patients undergoing radiofrequency catheter ablation

Qiqi WANG ¹, Xingang SUN ¹, Chengui ZHUO ¹, Miao CHEN ¹, Minglan WU ², Jianqiang ZHAO ¹, Zhongyuan LIN ³, Yuan HUANG ¹, Jiangtao LAI ¹, Zheyue SHU ⁴, Liangrong ZHENG ¹ ✉

¹ Department of Cardiology, Atrial Fibrillation Center, First Affiliated Hospital of Zhejiang University, Hangzhou, China; ² Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, Research Center for Clinical Pharmacy, First Affiliated Hospital of Zhejiang University, Hangzhou, China; ³ Department of Cardiovascular Medicine, Haining People’s Hospital, Jiaxing, China; ⁴ Department of Hepatobiliary Surgery, First Affiliated Hospital of Zhejiang University, Hangzhou, China

BACKGROUND: Hypertension is an important target for interventions to improve ablation outcome in atrial fibrillation (AF) patients. No studies to date have determined the blood pressure level at which AF is less likely to recur in patients without hypertension.
METHODS: A total of 503 AF patients undergoing radiofrequency catheter ablation (RFCA) (mean age, 59.6±9.6 years; 319 males [63.4%]) were identified for the study cohort and analysis. Patients received a pocket diary to record their home blood pressure (HBP) before RFCA and routine 48-hour Holter-ECGs to evaluate AF recurrence after RFCA.
RESULTS: A total of 383 (76.1%) patients were free of AF recurrence one year after RFCA. Blood pressure (BP), including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP), had different effects on AF recurrence one year after RFCA. A χ2 test showed that when SBP was <110 mmHg, it was associated with a lower AF recurrence in patients with hypertension (P=0.029). AF recurrence decreased (P=0.002) when SBP increased from <110 mmHg to >130 mmHg in patients without hypertension. Regression analysis indicated a significant linear correlation between BP and LAD in all patients.
CONCLUSIONS: SBP should be strictly maintained at 110 mmHg after RFCA to minimize AF recurrence in patients with hypertension. Low SBP might be a risk factor for AF recurrence among patients without hypertension.

KEY WORDS: Atrial fibrillation; Recurrence; Catheter ablation; Radiofrequency ablation; Blood pressure