Key result
Continuous cuffless BP monitoring reveals ~84% nocturnal non-dipping prevalence in rate-controlled AF.
Why the study?
Ambulatory blood pressure monitoring is challenging in atrial fibrillation due to beat-to-beat variability, which limits the characterization of circadian blood pressure patterns in these patients.
Does continuous 24-hour monitoring using a PPG-based ring-type wearable cuffless blood pressure device characterize circadian blood pressure and heart rate profiles in patients with rate-controlled paroxysmal atrial fibrillation?
Observational (n=50)
Does continuous 24-hour monitoring using a PPG-based ring-type wearable cuffless blood pressure device characterize circadian blood pressure and heart rate profiles in patients with rate-controlled paroxysmal atrial fibrillation?
Continuous cuffless wearable blood pressure monitoring is feasible for 24-hour assessment in patients with rate-controlled atrial fibrillation and reveals an 84% prevalence of nocturnal blood pressure non-dipping that correlates with blunted nocturnal heart rate reduction.
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“Using the CART blood pressure monitor, we achieved an analyzable data rate of approximately 80%, demonstrating the utility of ring-type 24-hour BP testing and enabling continuous observation of nocturnal dipping patterns.”
Non-dipping occurs in most rate-controlled AF patients and associates with blunted nocturnal HR reduction; hypothesis-generating and should not yet change practice.
Background Ambulatory blood pressure monitoring (ABPM) may be challenging in atrial fibrillation (AF) due to beat-to-beat variability, limiting characterization of circadian blood pressure (BP) patterns in this population. Purpose To evaluate the feasibility of continuous cuffless 24-hour BP monitoring and to characterize circadian BP–heart rate profiles in patients with rate-controlled paroxysmal atrial fibrillation. Methods In this prospective pilot study, 50 patients with rate-controlled AF (mean age 69±12 years) underwent 24-hour monitoring using a PPG based ring type wearable cuffless BP monitoring device. Mean 24-hour, daytime (awake), and nighttime (asleep) systolic/diastolic BP and HR were calculated from successful measurements only. Nocturnal systolic dipping was defined as a ≥10% reduction in nighttime versus daytime systolic BP. Day–night differences were assessed using paired t-tests. The association between nocturnal HR reduction and systolic dipping was evaluated using Pearson correlation and multivariable linear regression. Results Participants achieved a mean monitoring duration of 23.9±0.5 hours, with 18.6±3.2 hours of analyzable BP data. Mean 24-hour BP was 120.7±10.0/77.6±7.8 mmHg. Daytime and nighttime BP were 123.1±10.1/79.9±8.2 and 117.5±10.6/74.6±8.0 mmHg, respectively (mean day–night differences: SBP 5.7 mmHg; DBP 5.3 mmHg; both p<0.001). Mean systolic dipping was 4.5±5.0%. Non-dipping (SBP dipping <10%) was present in 42/50 (84%), and reverse dipping (<0%) in 7/50 (14%). HR decreased from 65.8±10.2 bpm to 60.3±9.8 bpm (nocturnal reduction 8.2±7.0%), which correlated with systolic dipping (r=0.32, p=0.025). In multivariable analysis, nocturnal HR reduction independently predicted systolic dipping (β=0.27, p=0.008), whereas mean BP levels were not associated. Conclusion Continuous cuffless monitoring enabled reliable 24-hour BP assessment in rate-controlled AF and revealed a high prevalence of non-dipping accompanied by blunted nocturnal heart rate reduction. These findings suggest altered circadian BP–HR regulation in AF and support wearable cuffless monitoring as a practical tool for nocturnal phenotype characterization.
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Lee et al. (2026) conducted an observational in Rate-controlled paroxysmal atrial fibrillation (n=50). PPG-based ring-type wearable cuffless 24-hour blood pressure monitoring device was evaluated on Prevalence of nocturnal systolic non-dipping (<10% reduction in nighttime vs daytime systolic BP) (MD 5.7 mmHg, p=<0.001). Continuous 24-hour cuffless BP monitoring in rate-controlled AF revealed an 84% prevalence of nocturnal systolic non-dipping, independently predicted by nocturnal HR reduction (β=0.27, p=0.008).
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