Abstract 15468: Acute Effect of Catheter Ablation Therapy on Blood Pressure in Patients with Atrial Fibrillation
Background: Previous studies demonstrated that the left atrial (LA) ablation influenced the autonomic tone by ablating ganglionated plexus, resulting in the increase of heart rate (HR) and reduction of HR variability in patients with atrial fibrillation (AF). However, the impact of the LA ablation on blood pressure (BP) has not yet been investigated.
Methods: A total of 58 patients with AF who underwent the initial ablation procedure (56±10 years, 52 males, paroxysmal AF: 32 and persistent AF: 26) was enrolled in this study. Twenty-four-hour ambulatory BP monitoring (ABPM) was performed in all patients both 2 days before and 2 days after the catheter ablation procedure. Pulmonary vein isolation (PVI) was performed in paroxysmal AF patients with the endpoint of the bidirectional block between PVs and the LA, while supplemental linear ablations (LA roof and mitral isthmus lines) were added in persistent AF patients with the endpoint of the bidirectional block across the lines.
Results: All PVs were successfully isolated from the LA, while the bidirectional conduction blocks of the LA roof and mitral isthmus lines were achieved except 1 patient. Mean HR significantly increased following the ablation procedure (69±12 vs. 74±9.5, P=0.004). Mean systolic BP (s-BP) significantly increased (119±10 vs. 122±11, P=0.006) and coefficient of variation (CV) of systolic and diastolic BP (d-BP) significantly decreased after the ablation procedure (CV of s-BP: 12±4.1 vs. 9.8±3.1 (P<0.001), CV of d-BP: 15±5.1 vs. 12±3.7 (P<0.001), respectively) (Figure). The reduction of CV in both s-BP and d-BP was significantly more prominent during awake than sleep ([[Unable to Display Character: ▵]]CV of s-BP: -2.5±5.0 vs. -0.8±5.0 (P=0.04), [[Unable to Display Character: ▵]]CV of d-BP: -2.9±6.0 vs. -0.6±6.0 (P=0.03), respectively).
Conclusion: The LA ablation involving PVI and the LA linear ablations influences not only HR but also BP with a reduction of CV, possibly due to vagal denervation by catheter ablation.
- © 2012 by American Heart Association, Inc.