Abstract 11808: Visit-to-visit Blood Pressure Variability Predicts Recurrence of Atrial Fibrillation in Patients With Hypertension

Introduction:Visit-to-visit blood pressure variability (VV-BPV) has been shown to be associated with cardiovascular risk in patients with hypertension (HT). However, it remains unclear whether the preprocedural VV-BPV can affect pulmonary vein isolation (PVI) outcome in atrial fibrillation (AF) patients with HT.Methods:Fifty-seven hypertensive AF patients (51 male; mean age, 63 ? 7 years) who underwent successful PVI were enrolled in the study and classified into 2 groups: Group 1 (n = 39), the patients who had no AF recurrence during the mean follow-up periods of 12 ? 6 months; and Group 2 (n = 18), those who showed AF recurrence. Systolic and diastolic VV-BPV (Sys-BPV and Dia-BPV) were calculated as standard deviation. For the evaluation of predictor of AF recurrence, Cox regression analysis was performed. Receiver-operating characteristic (ROC) analysis was performed to calculate the optimal cut off value. Kaplan-Meyer analysis was performed to evaluate the effect of VV-BPV on PVI outcome. The endpoint of the study was AF reccurrence, defined as the documentation of AF lasting over 30 sec.Results:Systolic BP and Sys-BPV in Group 2 were higher than those in Group 1 (139 ? 22 mmHg vs. 127 ? 16mmHg, P = 0.025; and 10.2 ? 3.4 vs. 7.8 ? 3.6, P = 0.021, respectively). There was no significant difference in diastolic BP and Dia-BPV between the 2 groups (P > 0.05). Cox multivariate regression analysis revealed that both Sys-BPV and Dia-BPV were the independent predictors of AF recurrence (Hazard ratio (HR): 1.125, P = 0.027; and HR 1.105, P = 0.045, respectively). ROC analysis revealed Sys-BPV of 9.4 and Dia-BPV of 6.5 as the cut-off values for AF recurrence. To evaluate the impact of cut-off value of Sys-BPV and Dia-BPV on PVI outcome, the study subjects were divided into two groups based on each cut-off of value. Kaplan-Meyer analysis showed that AF recurrence rate in high Sys-BPV and Dia-BPV was significantly higher than that in low Sys-BPV and Dia-BPV groups (P = 0.035 and P = 0.002, respectively).Conclusions:The findings of the current study suggested that VV-BPV is useful for the prediction of recurrence of AF after PVI in hypertensive patients.