DOI: 10.1161/circ.148.suppl_1.15200 ISSN: 0009-7322

Abstract 15200: Impact of Nocturnal Blood Pressure Fall on Long-Term Outcome for Recurrence of Atrial Fibrillation After Catheter Ablation

Tomonori Watanabe, Satoshi Hoshide, Hitoshi Hachiya, Hiroaki Watanabe, Takafumi Okuyama, Ayako Yokota, Masashi Kamioka, Takahiro Komori, Hisaki Makimoto, Tomoyuki Kabutoya, Yasushi Imai, Kazuomi Kario
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Introduction: Hypertension is known as a risk factor to progress the etiology of atrial fibrillation (AF). However, influence of non-dipper on AF recurrence after pulmonary vein isolation (PVI) remains unknown.

Methods: We investigated the clinical impact of non-dipper evaluated by 24-hour ambulatory BP monitoring on the long-term outcome for AF recurrence in 76 AF patients underwent the PVI.

Results: All of 76 patients (mean age:66±9 years, hypertension:78%, non-paroxysmal AF:24%) had procedural success of PVI. Twenty patients had AF recurrence during follow-up of median of 1158 days post-PVI. There was no difference in BP level between the AF recurrence and non-recurrence groups (average 24h-systolic BP:126±17 vs. 125±14mmHg, P=0.84). On the other hand, the patients with non-dipper had a higher AF recurrence than those with dipper (38.9% vs. 15.0%, P=0.018). In Cox hazard analysis adjusted by age, non-paroxysmal AF, and average 24h-systolic BP level, the non-dipper was an independent predictor of AF recurrence (HR 2.78 [95%CI: 1.05-7.34], P=0.039). The patients with non-dipper had a larger left atrial (LA) volume index than those with dipper (45.9±17.3 vs. 38.3±10.2ml, P=0.037). In 58 patients underwent the high-density voltage mapping in LA, 11 patients had low voltage area (LVA) defined as an area with a bipolar voltage < 0.5mV. There was no difference in existence of LVA between patients with non-dipper and those with dipper (22.2% vs. 16.1%, P=0.555).

Conclusions: Non-dipper is an independent predictor of AF recurrence after PVI. Management for abnormal diurnal BP variation may be important in patients after PVI.

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