Catheter ablation for atrial fibrillation in a subset of patients with concomitant hypertension

作     者：Tushar Sharma Benjamin J Scherlag Hiroshi Nakagawa Warren M Jackman Ralph Lazzara Sunny S Po 

作者机构：Heart Rhythm Institute at the University of Oklahoma Health Sciences CenterOklahoma CityOK 73104United States 

出 版 物：《World Journal of Hypertension》 (世界高血压杂志)

年 卷 期：2015年第5卷第2期

页      面：98-103页

学科分类：10[医学] 

基　　金：Supported by The Heart Rhythm Institute at the University of Oklahoma Health Sciences Center(SSP)and the Helen Wil Webster Arrhythmia Research Fund of the University of Oklahoma Foundation(BJS) 

主　　题：Atrial fibrillation Hypertension Autonomic nervous system Catheter ablation 

摘      要：AIM:To study patients with atrial fibrillation and hypertension who had successful catheter ablation for changes in blood pressure 1 year ***:A retrospective study was performed on patients who had catheter ablation for atrial fibrillation(AF) and hypertension(HTN) which included local autonomic ganglionated plexi denervation and pulmonary veins *** the records of 119 patients,followup data was found in order to determine the presence of sinus rhythm and data on systolic(SBP) and diastolic blood pressure at 2 wk,3 mo,6 mo and 1 year after the ablation *** echocardiograms were taken at the time of the catheter procedure to determine left atrial dimensions(LADs) and left ventricular ***:There was no significant difference in the preablation mean blood pressures between the two groups(P = 0.08).After 1 year 33 of the 60 with AF and HTN were in sinus rhythm,of whom 12 had normal LADs,≤ 4 cm Group 1,and 21 had enlarged left atria(LADs 4 cm,Group 2).For Group 1,at 1 year of follow up,there was a significant difference in the SBP(119.2 ± 13 mm Hg) compared to pre-ablation(142.6 ± 13.7 mm Hg,P = 0.001).For Group 2,there was no significant difference in the SBP,pre-ablation(130.3 ± 17.5 mm Hg) and at 1 year of follow up(130.4 ± 13.4 mm Hg,P = 0.75).All patients were on similar anti-hypertensive *** was a trend for a greater left ventricular size in Group 2 compared to Group ***:We suggest that Group 1 had HTN due to sympathetic hyperactivity,neurogenic HTN;whereas HTN in Group 2 was based on arterial vasoconstriction.