PS-C02-3: GREATER BLOOD PRESSURE VARIABILITY MEASURED BY 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING PREDICTS THE RECURRENCE AFTER ATRIAL FIBRILLATION CATHETER ABLATION

Abstract

Objective: Atrial fibrillation (AF) is an important prognostic factor even in the general population, and its clinical importance is increasing with the aging of the population. In recent years, catheter ablation (CA) of AF has become a common treatment modality, but recurrence of AF is observed in some patients. Especially, hypertension is an important risk factor for recurrence of AF after CA. Regarding blood pressure measurement, ambulatory blood pressure monitoring (ABPM) is known to provide a better prediction of cardiovascular events compared to conventional clinical BP measurement. However, the association between ambulatory BP variables (BPV) and AF recurrence after CA remains unclear. The purpose pf this study is to identify the association between BPV measured by 24-Hour ABPM device and recurrence after CA for AF. Design and method: All patients were admitted in Osaka metropolitan university hospital to undergo CA of AF, and were measured 24-hour BP monitoring using an ambulatory BP device (Mobil-O-Graph) after CA between August 2017 and April 2021. Twenty four-hour mean peripheral and central systolic/diastolic BP were separately calculated. BPV was calculated as coefficient of variation (standard deviation/mean BP). Results: A total of 107 patients were included in this study. After a median follow-up period of 563 days, AF recurrence was documented in 23 of 107 patients (21.5%). In univariate analysis, patients with AF recurrence tended to have higher age (OR = 1.08, 95%CI = 1.02–1.14, p < 0.01), serum BNP (OR = 1.00, 95%CI = 1.00–1.01, p = 0.01), CHADs2 VASc score (OR = 1.67, 95%CI = 1.22–2.29, p < 0.01), left atrial volume index (OR = 1.07, 95%CI = 1.04–1.10, p < 0.01), E/e’ (OR = 1.11, 95%CI = 1.02–1.21, p = 0.02) than those of non-AF recurrence. In ABPM variables, greater 24-hour mean peripheral and central systolic/diastolic BPV were associated with AF recurrence after CA, whereas any indices of 24-hour mean BP variables were not (Table 1.). Multivariate cox regression analysis after adjustment for relevant variables, 24-hour mean peripheral and central systolic/diastolic BPV were independently associated with AF recurrence after CA (Table 1.). Conclusions: Greater BPV measured by ABPM, either in peripheral or central, were indicated to be predictors of AF recurrence after CA. Our data suggest that BP control to aim at minimizing BPV attenuates the risk of AF recurrence after CA.