Abstract 14303: Impact of Uncontrolled Hypertension on Atrial Fibrillation Ablation Outcome
Introduction: Atrial fibrillation and hypertension are usually linked to each other. We sought to compare the impact of hypertension on the outcome of catheter ablation of AF.
Methods: 531 consecutive patients undergoing catheter ablation for atrial fibrillation were enrolled in this study. Patients were divided into 3 groups: patients with uncontrolled hypertension by medical treatment (group I, n=160), patients with controlled hypertension with medical therapy (group II, n=192), and patients without hypertension (group III, n=179). In all patients pulmonary vein antrum and posterior wall isolation was performed. Isoproterenol challenge up to 20 mcg/min to disclose non PV triggers was performed in all patients. All patients underwent extensive follow up.
Results: Non PV triggers were present in 78 (48.8%), 64 (33.3%) and 50 (27.9%) of groups I, II and III respectively (p<0.001). After 19 ± 7.7 months follow up, 65 (40.6%) group I, 54 (28.1%) group II and 46 (25.7%) group III had recurrences (p=0.003). After adjusting for confounders, group I pts had higher risk of recurrence [HR=1.66, (1.12, 2.44), p=0.01]. Risk for recurrence was similar between group II and III. Interestingly freedom from AT/AF in patients from group I was statistically different among patients with and without non-pv triggers ablation [25/36(69.4%) vs. 15/42 (36.8%,p=0.002].(Figure).
Conclusion: This prospective study shows that hypertension does not play a relevant role on the outcome of AF patients undergoing ablation for AF. However, in the uncontrolled hypertension pts a higher number of non-PV trigger requiring additional ablation was found.
- © 2013 by American Heart Association, Inc.