Key result
Higher nighttime very short-term BPV linked to ~48% lower AF recurrence after first-time ablation.
Why the study?
Prior studies suggest associations between blood pressure variability and AF recurrence, but the relevance of very short-term, beat-to-beat BPV remains uncertain.
Does higher very short-term blood pressure variability predict lower atrial fibrillation recurrence in patients undergoing first-time catheter ablation?
Cohort (n=153)
No
Does higher very short-term blood pressure variability predict lower atrial fibrillation recurrence in patients undergoing first-time catheter ablation?
Higher nighttime very short-term blood pressure variability, measured via cuffless monitoring, is associated with a lower risk of atrial fibrillation recurrence after first-time catheter ablation.
Should not yet change post-ablation monitoring; hypothesis-generating for nighttime BPV as AF recurrence marker.
Background: Blood pressure variability (BPV) is a cardiovascular risk marker independent of mean blood pressure. Prior studies have suggested potential associations between BPV and atrial fibrillation (AF) recurrence, but the relevance of very short-term, beat-to-beat BPV remains uncertain. Methods: In this single-center retrospective cohort study, we enrolled 153 consecutive patients undergoing first-time AF ablation who underwent pre-procedural overnight polygraphy with simultaneous pulse transit time-based beat-to-beat blood pressure monitoring. Very short-term BPV was quantified as the standard deviation (SD) of nighttime beat-to-beat systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP); patients were dichotomized at the median. The primary endpoint was the first recurrence of AF lasting ≥ 30s beyond a 3-month blanking period during 12 months of follow-up. In univariable Cox proportional hazards models, higher BPV was associated with lower recurrence risk (SD of SBP: hazard ratio 0.519, 95% confidence interval 0.311-0.865; SD of DBP: hazard ratio 0.258, 95% confidence interval 0.101-0.664; and SD of MBP: hazard ratio 0.251, 95% confidence interval 0.099-0.638). Conclusion: Higher nighttime very short-term BPV was associated with lower AF recurrence after first-time ablation. Pulse transit time-based cuffless monitoring may provide a practical method for preprocedural risk stratification; confirmation via multicenter studies is warranted.
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Murota et al. (2026) conducted a cohort in Atrial fibrillation (n=153). Higher very short-term blood pressure variability vs. Lower very short-term blood pressure variability was evaluated on First recurrence of AF lasting ≥ 30s beyond a 3-month blanking period (HR 0.519, 95% CI 0.311-0.865, p=0.003). Higher nighttime very short-term blood pressure variability was associated with lower atrial fibrillation recurrence after first-time ablation (SD of SBP: HR 0.519; 95% CI 0.311-0.865).
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