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The effects of radio-frequency ablation on blood pressure control in patients with atrial fibrillation and hypertension

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Abstract

Purpose

The effects of radio-frequency ablation (RFA) on blood pressure (BP) regulation in patients with atrial fibrillation (AF) and hypertension remain unknown. We hypothesized that patients with successful ablation had a lower BP and/or lesser utilization of antihypertensive drug therapy during follow-up when compared to patients with failed ablation.

Methods and results

This was a retrospective evaluation of patients with AF and hypertension treated with ablation at the University of Utah between July 2006 and June 2010. BP and use of antihypertensive medications were assessed at baseline and 1 year follow-up. A total of 167 patients were identified. Eight patients were excluded due to the need for AAD therapy beyond the blanking period thus leaving 80 patients in the success group and 79 patients in the failure group. The mean BP and HR at baseline were not significant between the groups. In the success group, the mean systolic BP decreased from a baseline value of 129 ± 17 to 125 ± 14 mmHg at 1 year (p = 0.075). In contrast, in the failure group, the mean systolic BP increased from a baseline value of 124 ± 16 to 127 ± 14 mmHg at 1 year (p = 0.176). Between-group comparison revealed a p value of 0.026. Minimal changes in diastolic BP were noted in both groups. No significant changes in antihypertensive therapy were noted.

Conclusion

We have shown that successful catheter ablation in patients with AF and hypertension is associated with a decrease in systolic BP when compared to an increase in patients with failed ablation. Our findings suggest that restoring sinus rhythm could have an antihypertensive effect in patients with AF and hypertension.

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Authors and Affiliations

  1. Division of Cardiology, University of Utah School of Medicine, 30 N 1900 E, Rm 4C104, Salt Lake City, UT, 84132, USA

    Alexies Ramirez & Christina F. Pacchia

  2. Division of Geriatrics, University of Utah School of Medicine, 30 N 1900 E, Rm 4C104, Salt Lake City, UT, 84132, USA

    Natalie A. Sanders

  3. Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, H4/534 Clinical Science Center, 600 Highland Avenue, Madison, WI, 53792-3248, USA

    Stephen L. Wasmund & Mohamed H. Hamdan

Authors
  1. Alexies Ramirez
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  2. Christina F. Pacchia
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  3. Natalie A. Sanders
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  4. Stephen L. Wasmund
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  5. Mohamed H. Hamdan
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Corresponding author

Correspondence to Mohamed H. Hamdan.

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Editorial commentary

This manuscript retrospectively evaluates the effects of radio-frequency ablation on BP regulation in hypertensive patients undergoing atrial fibrillation (AF) radio-frequency ablation. In the group with a successful ablation, the mean systolic BP had a trend decrease from a baseline value of 129 ± 17 to 125 ± 14 mmHg at 1 year (p = 0.075). Versus in those with a failed ablation, the mean systolic BP trend increased from a baseline value of 124 ± 16 to 127 ± 14 mmHg at 1 year (p = 0.176). Minimal changes in diastolic BP were noted in both groups. No significant changes in antihypertensive therapy were noted. The authors conclude that successful catheter ablation in patients with AF and hypertension is associated with a decrease in systolic BP when compared to an increase in patients with failed ablation. These preliminary findings suggest that restoring sinus rhythm could have an antihypertensive effect in patients with AF and hypertension.

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Ramirez, A., Pacchia, C.F., Sanders, N.A. et al. The effects of radio-frequency ablation on blood pressure control in patients with atrial fibrillation and hypertension. J Interv Card Electrophysiol 35, 285–291 (2012). https://doi.org/10.1007/s10840-012-9716-z

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  • DOI: https://doi.org/10.1007/s10840-012-9716-z

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