Impact of nocturnal blood pressure dipping on recurrence of atrial fibrillation after pulmonary vein isolation
Lack of the typical nocturnal blood pressure (BP) fall, i.e non-dipper, has been known as a cardiovascular risk. However, the influence of non-dipper on atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) has been unclear. We investigated the clinical impact of non-dipping as ev...
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| Veröffentlicht in: | Hypertension research 2024-06, Vol.47 (6), p.1688 |
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| creator | Watanabe, Tomonori Hoshide, Satoshi Hachiya, Hitoshi Yumita, Yoshiyuki Sato, Masafumi Mitama, Tadayuki Okuyama, Takafumi Watanabe, Hiroaki Yokota, Ayako Kamioka, Masashi Komori, Takahiro Makimoto, Hisaki Kabutoya, Tomoyuki Imai, Yasushi Kario, Kazuomi |
| description | Lack of the typical nocturnal blood pressure (BP) fall, i.e non-dipper, has been known as a cardiovascular risk. However, the influence of non-dipper on atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) has been unclear. We investigated the clinical impact of non-dipping as evaluated by 24-hour ambulatory BP monitoring on the long-term outcome of AF recurrence post-PVI in 76 AF patients with a history of increased BP. The PVI procedure was successful in all 76 patients (mean age, 66±9years; antihypertensive medication, 89%; non-paroxysmal AF, 24%). Twenty patients had AF recurrence during a median follow-up of 1138 days. There was no difference in BP levels between the AF recurrence and non-recurrence groups (average 24 h systolic BP:126 ± 17 vs.125 ± 14 mmHg; P = 0.84). On the other hand, the patients with non-dipper had a higher AF recurrence than those with dipper (38.9% vs.15.0%; P = 0.018). In Cox hazard analysis adjusted by age, non-paroxysmal AF and average 24-hr systolic BP level, the non-dipper was an independent predictor of AF recurrence (HR 2.78 [95%CI:1.05-7.34], P = 0.039). Non-dipper patients had a larger left atrial (LA) volume index than the dipper patients (45.9 ± 17.3 vs.38.3 ± 10.2 ml/m
, P = 0.037). Among the 58 patients who underwent high-density voltage mapping in LA, 11 patients had a low-voltage area (LVA) defined as an area with a bipolar voltage |
| doi_str_mv | 10.1038/s41440-024-01645-3 |
| format | Article |
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, P = 0.037). Among the 58 patients who underwent high-density voltage mapping in LA, 11 patients had a low-voltage area (LVA) defined as an area with a bipolar voltage < 0.5 mV. However, there was no association of LVA with non-dipper or dipper (22.2% vs.16.1%, P = 0.555). Non-dipper is an independent predictor of AF recurrence post-PVI. Management of abnormal diurnal BP variation post-PVI may be important.</description><identifier>ISSN: 0916-9636</identifier><identifier>ISSN: 1348-4214</identifier><identifier>EISSN: 1348-4214</identifier><identifier>DOI: 10.1038/s41440-024-01645-3</identifier><identifier>PMID: 38532036</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Blood Pressure - physiology ; Blood Pressure Monitoring, Ambulatory ; Catheter Ablation ; Circadian Rhythm - physiology ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Veins - physiopathology ; Pulmonary Veins - surgery ; Recurrence ; Treatment Outcome</subject><ispartof>Hypertension research, 2024-06, Vol.47 (6), p.1688</ispartof><rights>2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c303t-a8c5832e7c1f0687184396823885812fd68dde4ce41c7ad524a51d0285a148843</citedby><cites>FETCH-LOGICAL-c303t-a8c5832e7c1f0687184396823885812fd68dde4ce41c7ad524a51d0285a148843</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38532036$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watanabe, Tomonori</creatorcontrib><creatorcontrib>Hoshide, Satoshi</creatorcontrib><creatorcontrib>Hachiya, Hitoshi</creatorcontrib><creatorcontrib>Yumita, Yoshiyuki</creatorcontrib><creatorcontrib>Sato, Masafumi</creatorcontrib><creatorcontrib>Mitama, Tadayuki</creatorcontrib><creatorcontrib>Okuyama, Takafumi</creatorcontrib><creatorcontrib>Watanabe, Hiroaki</creatorcontrib><creatorcontrib>Yokota, Ayako</creatorcontrib><creatorcontrib>Kamioka, Masashi</creatorcontrib><creatorcontrib>Komori, Takahiro</creatorcontrib><creatorcontrib>Makimoto, Hisaki</creatorcontrib><creatorcontrib>Kabutoya, Tomoyuki</creatorcontrib><creatorcontrib>Imai, Yasushi</creatorcontrib><creatorcontrib>Kario, Kazuomi</creatorcontrib><title>Impact of nocturnal blood pressure dipping on recurrence of atrial fibrillation after pulmonary vein isolation</title><title>Hypertension research</title><addtitle>Hypertens Res</addtitle><description>Lack of the typical nocturnal blood pressure (BP) fall, i.e non-dipper, has been known as a cardiovascular risk. However, the influence of non-dipper on atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) has been unclear. We investigated the clinical impact of non-dipping as evaluated by 24-hour ambulatory BP monitoring on the long-term outcome of AF recurrence post-PVI in 76 AF patients with a history of increased BP. The PVI procedure was successful in all 76 patients (mean age, 66±9years; antihypertensive medication, 89%; non-paroxysmal AF, 24%). Twenty patients had AF recurrence during a median follow-up of 1138 days. There was no difference in BP levels between the AF recurrence and non-recurrence groups (average 24 h systolic BP:126 ± 17 vs.125 ± 14 mmHg; P = 0.84). On the other hand, the patients with non-dipper had a higher AF recurrence than those with dipper (38.9% vs.15.0%; P = 0.018). In Cox hazard analysis adjusted by age, non-paroxysmal AF and average 24-hr systolic BP level, the non-dipper was an independent predictor of AF recurrence (HR 2.78 [95%CI:1.05-7.34], P = 0.039). Non-dipper patients had a larger left atrial (LA) volume index than the dipper patients (45.9 ± 17.3 vs.38.3 ± 10.2 ml/m
, P = 0.037). Among the 58 patients who underwent high-density voltage mapping in LA, 11 patients had a low-voltage area (LVA) defined as an area with a bipolar voltage < 0.5 mV. However, there was no association of LVA with non-dipper or dipper (22.2% vs.16.1%, P = 0.555). Non-dipper is an independent predictor of AF recurrence post-PVI. Management of abnormal diurnal BP variation post-PVI may be important.</description><subject>Aged</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Blood Pressure - physiology</subject><subject>Blood Pressure Monitoring, Ambulatory</subject><subject>Catheter Ablation</subject><subject>Circadian Rhythm - physiology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pulmonary Veins - physiopathology</subject><subject>Pulmonary Veins - surgery</subject><subject>Recurrence</subject><subject>Treatment Outcome</subject><issn>0916-9636</issn><issn>1348-4214</issn><issn>1348-4214</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kE1PxCAQhonRuOvqH_BgOHpBgaFdejTGj0028aJnwgI1mBYqtCb-e1m7eprDPO-bmQehS0ZvGAV5mwUTghLKBaGsFhWBI7RkICQRnIljtKQNq0lTQ71AZzl_UMpl1bBTtABZAadQL1HY9IM2I44tDtGMUwq6w7suRouH5HKeksPWD4MP7zgGnJyZUnLBuH1Cj8kXvPW75LtOj74Quh1dwsPU9THo9I2_nA_Y5zivz9FJq7vsLg5zhd4eH17vn8n25Wlzf7clBiiMREtTSeBubVhLa7lmUkBTSw5SVpLx1tbSWieME8ysta240BWz-_c0E7LAK3Q99w4pfk4uj6r32bhyZHBxygooBQGlkRWUz6hJMefkWjUk35fTFaNq71nNnlXxrH49Kyihq0P_tOud_Y_8iYUfVzN5rg</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Watanabe, Tomonori</creator><creator>Hoshide, Satoshi</creator><creator>Hachiya, Hitoshi</creator><creator>Yumita, Yoshiyuki</creator><creator>Sato, Masafumi</creator><creator>Mitama, Tadayuki</creator><creator>Okuyama, Takafumi</creator><creator>Watanabe, Hiroaki</creator><creator>Yokota, Ayako</creator><creator>Kamioka, Masashi</creator><creator>Komori, Takahiro</creator><creator>Makimoto, Hisaki</creator><creator>Kabutoya, Tomoyuki</creator><creator>Imai, Yasushi</creator><creator>Kario, Kazuomi</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240601</creationdate><title>Impact of nocturnal blood pressure dipping on recurrence of atrial fibrillation after pulmonary vein isolation</title><author>Watanabe, Tomonori ; Hoshide, Satoshi ; Hachiya, Hitoshi ; Yumita, Yoshiyuki ; Sato, Masafumi ; Mitama, Tadayuki ; Okuyama, Takafumi ; Watanabe, Hiroaki ; Yokota, Ayako ; Kamioka, Masashi ; Komori, Takahiro ; Makimoto, Hisaki ; Kabutoya, Tomoyuki ; Imai, Yasushi ; Kario, Kazuomi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c303t-a8c5832e7c1f0687184396823885812fd68dde4ce41c7ad524a51d0285a148843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Blood Pressure - physiology</topic><topic>Blood Pressure Monitoring, Ambulatory</topic><topic>Catheter Ablation</topic><topic>Circadian Rhythm - physiology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pulmonary Veins - physiopathology</topic><topic>Pulmonary Veins - surgery</topic><topic>Recurrence</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Watanabe, Tomonori</creatorcontrib><creatorcontrib>Hoshide, Satoshi</creatorcontrib><creatorcontrib>Hachiya, Hitoshi</creatorcontrib><creatorcontrib>Yumita, Yoshiyuki</creatorcontrib><creatorcontrib>Sato, Masafumi</creatorcontrib><creatorcontrib>Mitama, Tadayuki</creatorcontrib><creatorcontrib>Okuyama, Takafumi</creatorcontrib><creatorcontrib>Watanabe, Hiroaki</creatorcontrib><creatorcontrib>Yokota, Ayako</creatorcontrib><creatorcontrib>Kamioka, Masashi</creatorcontrib><creatorcontrib>Komori, Takahiro</creatorcontrib><creatorcontrib>Makimoto, Hisaki</creatorcontrib><creatorcontrib>Kabutoya, Tomoyuki</creatorcontrib><creatorcontrib>Imai, Yasushi</creatorcontrib><creatorcontrib>Kario, Kazuomi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hypertension research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Watanabe, Tomonori</au><au>Hoshide, Satoshi</au><au>Hachiya, Hitoshi</au><au>Yumita, Yoshiyuki</au><au>Sato, Masafumi</au><au>Mitama, Tadayuki</au><au>Okuyama, Takafumi</au><au>Watanabe, Hiroaki</au><au>Yokota, Ayako</au><au>Kamioka, Masashi</au><au>Komori, Takahiro</au><au>Makimoto, Hisaki</au><au>Kabutoya, Tomoyuki</au><au>Imai, Yasushi</au><au>Kario, Kazuomi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of nocturnal blood pressure dipping on recurrence of atrial fibrillation after pulmonary vein isolation</atitle><jtitle>Hypertension research</jtitle><addtitle>Hypertens Res</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>47</volume><issue>6</issue><spage>1688</spage><pages>1688-</pages><issn>0916-9636</issn><issn>1348-4214</issn><eissn>1348-4214</eissn><abstract>Lack of the typical nocturnal blood pressure (BP) fall, i.e non-dipper, has been known as a cardiovascular risk. However, the influence of non-dipper on atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) has been unclear. We investigated the clinical impact of non-dipping as evaluated by 24-hour ambulatory BP monitoring on the long-term outcome of AF recurrence post-PVI in 76 AF patients with a history of increased BP. The PVI procedure was successful in all 76 patients (mean age, 66±9years; antihypertensive medication, 89%; non-paroxysmal AF, 24%). Twenty patients had AF recurrence during a median follow-up of 1138 days. There was no difference in BP levels between the AF recurrence and non-recurrence groups (average 24 h systolic BP:126 ± 17 vs.125 ± 14 mmHg; P = 0.84). On the other hand, the patients with non-dipper had a higher AF recurrence than those with dipper (38.9% vs.15.0%; P = 0.018). In Cox hazard analysis adjusted by age, non-paroxysmal AF and average 24-hr systolic BP level, the non-dipper was an independent predictor of AF recurrence (HR 2.78 [95%CI:1.05-7.34], P = 0.039). Non-dipper patients had a larger left atrial (LA) volume index than the dipper patients (45.9 ± 17.3 vs.38.3 ± 10.2 ml/m
, P = 0.037). Among the 58 patients who underwent high-density voltage mapping in LA, 11 patients had a low-voltage area (LVA) defined as an area with a bipolar voltage < 0.5 mV. However, there was no association of LVA with non-dipper or dipper (22.2% vs.16.1%, P = 0.555). Non-dipper is an independent predictor of AF recurrence post-PVI. Management of abnormal diurnal BP variation post-PVI may be important.</abstract><cop>England</cop><pmid>38532036</pmid><doi>10.1038/s41440-024-01645-3</doi></addata></record> |
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| subjects | Aged Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Blood Pressure - physiology Blood Pressure Monitoring, Ambulatory Catheter Ablation Circadian Rhythm - physiology Female Humans Male Middle Aged Pulmonary Veins - physiopathology Pulmonary Veins - surgery Recurrence Treatment Outcome |
| title | Impact of nocturnal blood pressure dipping on recurrence of atrial fibrillation after pulmonary vein isolation |
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