ARTERIAL BLOOD PRESSURE DYNAMICS IN PATIENTS WITH ARTERIAL HYPERTENSION AND PERMANENT ATRIAL FIBRILLATION AFTER AV-NODAL ABLATION AND PACEMAKER IMPLANTATION: PP.1.51

Abstract

Patients with permanent atria fibrillation (AF) and arterial hypertension (AH) need not only blood pressure correction but also a heart rate control. There are patients who unsuccessful in heart rate control with medication. That is why these patients were performed AV-nodal ablation and pacemaker implantation. Objective: To assess the possibility of AH monotherapy in patients with chronic AF with ablated AV-node and SR pacemaker implanted. Design and Method: 92 patients involved (47 females), median age was 63.1 ± 6,4. Systolic blood pressure (SBP) 156 ± 4.9 mmHg, diastolic blood pressure (DBP) 86 ± 4.4 mmHg. For different reasons ACE-inhibitors were contraindicated. An average AH anamnesis was 9.7 ± 5,6 years. AF duration at average was 9.3 ± 4.5 years. Continuous pacing duration was 5.2 ± 1.7 years. In 71 patients NYHA heard failure class was II and the rest of them had III. BP checked with 24-hour monitoring. Patients were randomized into two groups. The first one consist of 52 patients who were taking Arifon-retard 1,5 mg in the morning for BP reduction and the second one involved 42 patients and they were taking Nebivolol in a day dose 2.5–5 mg. Results: The treatment efficacy was assessed after 12 and 18 months by the 24-hour BP monitoring results, end diastolic size (EDS) of left ventricle and heart failure functional class. In Nebivolol group aimed BP (SBP<140 mmHg and DBP<90 mmHg) was achieved in 43 (82,7%) patients, EDS decreased in 36 (69,2%) patients. In Arifon-retard group aimed BP achieved in 31 (77,5%), EDS reduction in 21 (52,5%) patients. Conclusions: In case when ACE-inhibitors are contraindicated a monotherapy of AH with Nebivolol or Arifon-retard is effective in patients with chronic atrial fibrillation, artificial complete heart block and implanted pacemaker.