Blood pressure variability as a risk factor of recurrent paroxysmal atrial fibrillation after catheter ablation

Abstract

Background

Blood pressure variability has been found to be a predictor of a stroke, heart failure, and ischemic heart disease that is independent of blood pressure control. This study used the variability independent of the mean (VIM) to evaluate the visit-to-visit blood pressure variability in patients previously undergoing catheter ablation (CA) of paroxysmal atrial fibrillation (PAF), and its relationship with AF recurrence was examined.

Method and Results

The subjects were 274 consecutive PAF patients who underwent CA at our hospital. Finally, 237 subjects were included in the analysis. The mean follow-up period was 29.6 months, during which 37 subjects had recurrences, and 200 did not. During the outpatient blood pressure examinations, the VIM of the systolic blood pressure (VIM SBP) was significantly higher in the recurrence group, suggesting that blood pressure variability is associated with recurrence. The Cox proportional hazards ratio of the VIM SBP was significantly higher in the recurrence (4.839) than no-recurrence group, even after an adjustment, suggesting that the extent of the variability was a risk factor of recurrence post-CA. In addition, the Cox proportional hazard ratio for recurrence was significantly lower in the patients taking dihydropyridine calcium channel blockers, suggesting that the risk of recurrence may differ depending on the type of antihypertensive drug.

Conclusions

Blood pressure variability may be a risk for AF recurrence after CA.