Περίληψη:
Introduction. Longitudinal studies on lone AF are rare and the incidence
of hypertension in this population unknown. This study aimed at
investigating the incidence of arterial hypertension in patients with
apparently lone atrial fibrillation (AF).
Methods and Results. Out of 292 consecutive patients presented with
permanent or paroxysmal AF, 32 patients were diagnosed as having lone AF
according to strict criteria. Three patients were subjected to ablation
of the ligament of Marshall, 14 patients to pulmonary vein isolation,
and the remainder were treated with beta blockade. Patients were
followed-up for a 1-3 year period. During follow-up, 14 patients were
diagnosed as having arterial hypertension. Thirteen of them had
recurrent AF despite ligament of Marshall ablation (1 patient),
pulmonary vein isolation (4 patients) and beta blockade (8 patients).
Cox regression analysis revealed that the only significant predictor of
development of hypertension was complete or partial response to
antiarrhythmic therapy (beta = 3.82, S.E. = 1.22, exp(b) = 45.63, 95%
C.I. = 4.17-499.2, p = 0.001), independent of age (beta = -0.01, p =
0.74), sex (beta = -0.91, p = 0.28), left ventricular ejection fraction
(beta = 0.06, p = 0.52), left atrial size (beta = 0.58, p = 0.7) and
kind of antiarrhythmic therapy (ablation or drug therapy) (beta = 1.36,
p = 0.09). In patients with lone AF that did not respond at all to
antiarrhythmic therapy, there was a 45.6 times higher risk of diagnosing
hypertension during the next 3 years as compared to responders.
Conclusion. Approximately 44% of patients with an initial diagnosis of
lone AF may represent occult cases of arterial hypertension. In these
patients hypertension may affect AF recurrence and treatment outcomes,
regardless of the mode of antiarrhythmic therapy used.
Συγγραφείς:
Katritsis, DG
Toumpoulis, IK
Giazitzoglou, E
Korovesis, S
and Karabinos, I
Paxinos, G
Zambartas, C
Anagnostopoulos, CE
