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Background: Hypertension (HTN) constitutes a risk factor for the development of atrial fibrillation (AF), as well as for thromboembolic and bleeding events. We analysed the outcome after catheter ablation of AF in HTN in a cohort from the prospective multicenter German Ablation Registry. Methods: Between 03/2008 and 01/2010, 626 patients undergoing AF-ablation were analysed. Patients diagnosed with HTN (n = 386) were compared with patients without HTN (n = 240) with respect to baseline, procedural and long-term outcome parameters. Results: Patients with HTN were older and more often presented with persistent forms of AF and cardiac comorbidities. Major and moderate in-hospital complications were low. At long-term follow-up, major cardiovascular events were rare in both groups. Rates of AF-recurrence, freedom from antiarrhythmic medication and repeat ablation were not statistically different between groups. Most patients reported improvement of symptoms and satisfaction with the treatment. However, patients with HTN more frequently complained of dyspnea of New York Heart Association (NYHA) class ≥ II and angina. They were more often rehospitalized, particularly when persistent AF had been diagnosed. Conclusion: Catheter ablation of AF is associated with low complication rates and favorable arrhythmia-related results in patients with HTN. Residual clinical symptoms may be due to cardiac comorbidities and require additional attention in this important subgroup of AF-patients. [ABSTRACT FROM AUTHOR]

Background: The 6-minute walk test (6MWT) is an established prognostic tool in chronic heart failure. The strong influence of height, weight, age, and sex on 6MWT distance may be accounted for by using percentage achieved of predicted value rather than uncorrected 6MWT values. Methods: The study included 1069 patients (862 men) with a mean age 55.2 ± 11.7 years and mean left ventricular ejection fraction of 29% ± 10%, attending the heart failure clinic of the University of Heidelberg between 1995 and 2005. The predictive power and accuracy of 6MWT and achieved percentage values according to all available published equations for mortality and mortality or transplant combined were tested separately for each sex. Results: The percentage values varied largely between equations. For all equations, women in New York Heart Association (NYHA) functional class I had higher values than men. Although the 6MWT significantly discriminated all NYHA classes for both sexes, only 1 equation discriminated all NYHA classes. No significant differences in the area under the receiver operating-characteristic curve were noted between achieved percentage values and 6MWT. Despite strong univariate significance, achieved percentage values did not retain multivariate significance. The 6MWT was independent from N-terminal brain natriuretic propeptide, NYHA, left ventricular ejection fraction, and peak oxygen uptake. Conclusion: We confirmed 6MWT to be a strong and independent risk predictor for both sexes. Because the prognostic power of 6MWT is not enhanced using percentage achieved of published reference equations, we suggest recalibration of these reference values rather than discarding this approach. [Copyright &y& Elsevier]