In:
Journal of Cardiovascular Electrophysiology, Wiley, Vol. 26, No. 5 ( 2015-05), p. 509-514
Abstract:
Hypertension is an established risk factor for new‐onset atrial fibrillation (AF). However, the relationship between blood pressure and recurrent AF is less well understood. Methods and Results A pooled analysis of patient‐level data from AFFIRM and AF‐CHF trials was conducted on all 2,715 patients with paroxysmal or persistent AF, 68 ± 8 years, 66% male, randomized to rhythm control and followed for 40.6 ± 16.5 months. We assessed the impact of a baseline systolic blood pressure (SBP; 〈 120 mmHg [N = 1,008], 120–140 mmHg [N = 930] , 〉 140 mmHg [N = 777]) on recurrent AF and proportion of time spent in AF. In patients with LVEF 〉 40% (N = 1,719), SBP was not associated with recurrent AF in multivariate regression analyses (P = 0.752). In contrast, in patients with LVEF ≤40% (N = 996), the AF recurrence rate was higher in those with an SBP 〉 140 mmHg compared to 120–140 mmHg (hazard ratio 1.47; 95% CI [1.12–1.93], P = 0.005). The rate of recurrent AF was similar in patients with SBP 〈 120 mmHg compared to 120–140 mmHg (hazard ratio 1.15; 95% CI [0.92–1.43], P = 0.225). Consistently, the proportion of time spent in AF was not influenced by SBP in patients with LVEF 〉 40% (P = 0.645). However, in patients with LVEF ≤40%, the adjusted mean proportion of time spent in AF was 17.2% if SBP was 〈 120 mmHg, 15.4% for SBP 120–140 mmHg, and 24.0% for SBP 〉 140 mmHg (P = 0.025). Conclusion Systolic blood pressure is an important determinant of recurrent AF and overall AF burden in patients with left ventricular dysfunction (LVEF≤40%) but not in those with preserved ventricular function.
Type of Medium:
Online Resource
ISSN:
1045-3873
,
1540-8167
DOI:
10.1111/jce.2015.26.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2015
detail.hit.zdb_id:
2037519-0