High central pulse pressure (≥45 mmHg) was associated with a significantly higher rate of atrial fibrillation recurrence following catheter ablation compared to lower central pulse pressure (87% vs 47%).
Observational (n=118)
No
Does increased aortic stiffness predict atrial fibrillation recurrence in patients with lone atrial fibrillation undergoing catheter ablation?
Increased central aortic stiffness is a significant predictor of atrial fibrillation recurrence following catheter ablation in patients with lone AF, suggesting occult vascular and atrial remodeling.
Absolute Event Rate: 87% vs 47%
p-value: p=0.008
BACKGROUND: Recent community-based research has linked aortic stiffness to the development of atrial fibrillation. We posit that aortic stiffness contributes to adverse atrial remodeling leading to the persistence of atrial fibrillation following catheter ablation in lone atrial fibrillation patients, despite the absence of apparent structural heart disease. Here, we aim to evaluate aortic stiffness in lone atrial fibrillation patients and determine its association with arrhythmia recurrence following radio-frequency catheter ablation. METHODS: We studied 68 consecutive lone atrial fibrillation patients who underwent catheter ablation procedure for atrial fibrillation and 50 healthy age- and sex-matched community controls. We performed radial artery applanation tonometry to obtain central measures of aortic stiffness: pulse pressure, augmentation pressure and augmentation index. Following ablation, arrhythmia recurrence was monitored at months 3, 6, 9, 12 and 6 monthly thereafter. RESULTS: Compared to healthy controls, lone atrial fibrillation patients had significantly elevated peripheral pulse pressure, central pulse pressure, augmentation pressure and larger left atrial dimensions (all P<0.05). During a mean follow-up of 2.9±1.4 years, 38 of the 68 lone atrial fibrillation patients had atrial fibrillation recurrence after initial catheter ablation procedure. Neither blood pressure nor aortic stiffness indices differed between patients with and without atrial fibrillation recurrence. However, patients with highest levels (≥75(th) percentile) of peripheral pulse pressure, central pulse pressure and augmentation pressure had higher atrial fibrillation recurrence rates (all P<0.05). Only central aortic stiffness indices were associated with lower survival free from atrial fibrillation using Kaplan-Meier analysis. CONCLUSION: Aortic stiffness is an important risk factor in patients with lone atrial fibrillation and contributes to higher atrial fibrillation recurrence following catheter ablation procedure.
Lau et al. (Thu,) conducted a observational in Lone Atrial Fibrillation (n=118). High central pulse pressure (≥75th percentile / ≥45 mmHg) vs. Lower central pulse pressure (<75th percentile / <45 mmHg) was evaluated on Atrial fibrillation recurrence after catheter ablation (p=0.008). High central pulse pressure (≥45 mmHg) was associated with a significantly higher rate of atrial fibrillation recurrence following catheter ablation compared to lower central pulse pressure (87% vs 47%).
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