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Background:  The impact of preprocedural visit-to-visit blood pressure variability (BPV) on pulmonary vein isolation (PVI) outcome in patients with hypertension (HTN) and atrial fibrillation (AF) remains unclear.  Methods and Results:  This study enrolled 138 AF patients with HTN who underwent successful PVI. Patients were classified into 2 groups, those with AF recurrence (AF-Rec; n=42) and those without AF recurrence (No-AF-Rec; n=96). Blood pressure (BP) was measured at least 3 times during sinus rhythm, and systolic and diastolic BPV (Sys-BPV and Dia-BPV, respectively) were defined as the standard deviation of BP. Clinical characteristics were compared between the 2 groups, and the relationship between BPV and AF recurrence was investigated. Sys-BPV and Dia-BPV were significantly higher in the AF-Rec than No-AF-Rec group (Sys-BPV: 10.6±3.7 vs. 6.9±3.5; Dia-BPV: 7.3±3.1 vs. 4.8±3.0; P&lt;0.05 for both). Receiver operating characteristic analysis revealed Sys-BPV 9.1 and Dia-BPV 5.7 as cut-off values for AF recurrence. Kaplan-Meyer analysis demonstrated higher AF recurrence in patients with Sys-BPV &gt;9.1 and Dia-BPV &gt;5.7 (P&lt;0.05 for both). Cox multivariate regression analysis revealed that Sys-BPV &gt;9.1 and Dia-BPV &gt;5.7 were independent predictors of AF recurrence (hazard ratios 3.736 and 2.958, respectively; P&lt;0.05 for both).  Conclusions:  Sys-BPV and Dia-BPV were associated with AF recurrence in AF patients with HTN.

circulation reports

Visit-to-Visit Blood Pressure Variability Predicts Atrial Fibrillation Recurrence After Pulmonary Vein Isolation in Patients With Hypertension and Atrial Fibrillation