Factors to predict recurrence of atrial fibrillation in patients with hypertension

Abstract

Backgound: Patients with essential hypertension had a higher recurrence rate of atrial fibrillation (AF) than patients without hypertension. This study evaluated the role of various parameters for predicting recurrence after conversion of AF in patients with essential hypertension. Methods: We retrospectively analyzed 136 patients with essential hypertension and a known history of AF. P-wave duration and dispersion were measured in a 12-lead electrocardiograph. The size and function of the left atrium (LA) and left atrial appendage (LAA) were assessed by transthoracic and transesophageal echocardiography. The time interval from initiation of P-wave to the start of LAA ejection flow (P-LAA) was measured at the same time. All the patients were followed up for a period of 12±6 months for the recurrence of AF. Results: In the follow-up period, 38.2%of patients underwent AF recurrence. Age, P-LAA, Pmax, P-wave dispersion, left atrium diameter (LAD), and maximum and minimum LAA volume were significantly higher in patients with AF recurrence than in patients without AF recurrence, while EF-LAA and LAA peak emptying velocity were much lower in patients with AF recurrence. P-LAA had positive correlation with LAD and P-wave dispersion (r = 0.501, p<0.0001; r = 0.713, p<0.0001). Conclusion: These results indicated that increased P-wave dispersion, P-LAA in addition to the dilated LA, and the depressed LAA function may be useful to identify patients with hypertension at risk of recurrent AF. © 2009 Wiley Periodicals, Inc.