Title Relative blood pressure increase is associated with subsequent atrial episodes in long-term out-patient monitoring: TriggersAF
Authors Bacevičius, Justinas ; Stankevičiūtė, Guostė ; Kersnauskaitė, Džiugilė ; Sokas, Daivaras ; Kundelis, Ričardas ; Dvinelis, Ernestas ; Abramikas, Žygimantas Jonas ; Pudinskaitė, Gintarė ; Radavičius, Vytautas ; Širvys, Artiomas ; Širvienė, Dominika ; Pugačiauskaitė, Kristina ; Burneikaitė, Greta ; Marozas, Vaidotas
DOI 10.1093/europace/euaf085.262
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Is Part of Europace: EHRA 2025 30 March – 1 April Vienna, Austria : abstract.. Oxford : Oxford University press. 2025, vol. 27, suppl. 1, p. i445-i447.. ISSN 1532-2092. eISSN 1099-5129
Keywords [eng] blood pressure ; atrial fibrillation ; telemonitoring
Abstract [eng] Background: The role of chronic blood pressure (BP) increase in atrial brillation (AF) pathogenesis is usually limited to risk factor assessment. Dynamic real-time BP uctuations before arrhythmia initiation remain poorly understood. This study aims to investigate the chronological changes of BP before AF. Methods: In this single-center prospective cohort study subjects with diagnosed paroxysmal or persistent AF underwent a 7-day outpatient telemonitoring. All patients were in sinus rhythm at the moment of inclusion. During the monitoring period, a continuous single-lead electrocardiogram (ECG) was registered. The recorded data was manually classi ed into four cardiac rhythm categories: atrial brillation, atrial tachycardia or utter, frequent premature atrial contractions, and no arrhythmia. In addition, arterial blood pressure (BP) measurements were obtained periodically for the rst 2 days at intervals of 15 minutes during the day, every 30 minutes during the night, followed by conventional BP measurements for the remaining observation period. BP data was synchronised with the ECG recordings. Systolic (SBP) and diastolic (DBP) values within 60 minutes before AF (investigational group) were compared to the control BP of the same patients measured in at least 2 consecutive hours with no AF detected. The analysis segregates day and night. Since AF tended to group into a series of episodes, a lter of a minimal duration without AF before the start of the episode was applied (5, 10, 20 or 30 minutes), aiming to select the initializing episode of the AF and avoid duplicate BP measurements. Results: The enrolment lasted from 2020 to 2023, resulting in 165 subjects, aged 59.0±11.8 years, 61.8% male. Physicians manually annotated a total duration of 26961 hours in a single-lead ECG analysis. Among detected atrial arrhythmia episodes 1520 were AF in 54 patients (Figure 1). The individual relative change of BP yielded an increase of SBP before daytime and nighttime AF and an increase of DBP before nighttime AF irrespective of the lter used (Figure 2). When no lter was applied the BP before AF vs. control was as follows, respectively: 1) Daytime SBP change +2% (±9) vs. 0% (±11), p<0.001 and nighttime +11% (±10) vs. 0% (±12), p<0.001; 2) Daytime DBP change 0% (±10) vs. 0% (±12), p=0.5 and nighttime +14% (±20) vs. 0% (±16), p<0.001. The absolute BP values did not differ between AF vs. control groups irrespective of the lter used. With 5-min lter: 1) Daytime SBP 125 (±13) vs. 127 (±17), p=0.5 and nighttime 118 (±15) vs. 117 (±18), p=0.5; 2) Daytime DBP 80 (±12) vs. 81 (±13), p=0.5 and at nighttime 68 (±15) vs. 68 (±15), p=0.8. Conclusions: This is the rst study to assess the chronological changes of BP before AF. Within 60 minutes before AF episodes the relative individual daytime and nighttime systolic BP and the relative individual nighttime diastolic BP increase. This, however, does not transfer to a difference in absolute BP values.
Published Oxford : Oxford University press
Type Conference paper
Language English
Publication date 2025