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Robotic Ablation of Atrial Fibrillation
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Impact of Uncontrolled Hypertension on Atrial Fibrillation Ablation Outcome

Francesco Santoro1, Luigi Di Biase2, Chintan Trivedi3

  • 1Department of Cardiology, University of Foggia, Foggia, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.

JACC. Clinical Electrophysiology
|May 16, 2018
PubMed

Insights

Uncontrolled hypertension increases atrial fibrillation (AF) recurrence after ablation. Controlled hypertension shows similar outcomes to no hypertension, suggesting tailored ablation strategies are needed for hypertensive AF patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Hypertension Research

Background:

  • Hypertension is a significant risk factor for developing atrial fibrillation (AF).
  • Understanding hypertension's impact on AF ablation outcomes is crucial for patient management.

Purpose of the Study:

  • To assess how hypertension affects the success rates of atrial fibrillation ablation.
  • To compare AF ablation outcomes in patients with uncontrolled hypertension, controlled hypertension, and no hypertension.

Main Methods:

  • 531 patients undergoing AF ablation were categorized into three groups: uncontrolled hypertension, controlled hypertension, and no hypertension.
  • Pulmonary vein antrum and posterior wall isolation were performed, with identification of non-pulmonary vein triggers.
  • Follow-up averaged 19 months to assess arrhythmia recurrence.

Main Results:

  • Uncontrolled hypertension was associated with larger left atrial size and more non-pulmonary vein triggers.
  • AF recurrence rates were significantly higher in the uncontrolled hypertension group (40.6%) compared to controlled (28.1%) and no hypertension (25.7%) groups.
  • Uncontrolled hypertension, non-pulmonary vein triggers, and nonparoxysmal AF were independent predictors of recurrence.

Conclusions:

  • Controlled hypertension does not negatively impact AF ablation outcomes.
  • Uncontrolled hypertension significantly increases the risk of AF recurrence post-ablation.
  • Patients with uncontrolled hypertension may benefit from more extensive ablation procedures targeting additional triggers.
Abstract

Keywords:
atrial fibrillationcatheter ablationhypertensionnon-PV triggerspulmonary vein isolationuncontrolled hypertension

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