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Title: Aggressive approach and outcome in patients presenting atrial fibrillation and hypertension. Author: Conti A, Canuti E, Mariannini Y, Zanobetti M, Innocenti F, Paladini B, Pepe G, Padeletti L, Gensini GF. Journal: Int J Cardiol; 2013 Jun 05; 166(1):50-4. PubMed ID: 21985755. Abstract: AIM: Aggressive approach in patients presenting atrial fibrillation (AF) and hypertension could result in improving rhythm control and reducing admission. METHODS: Out of 3475 patients presenting AF, those with hypertension (n=1739, 52%) underwent standard (n=591, group 1, years 2004-2005) or aggressive pharmacological and electrical approach (n=1148, group 2, years 2006-2009). Overall, in 1071 patients AF duration was less than 48 h. Primary endpoint was rhythm conversion; secondary endpoints were modalities of rhythm conversion and reduction of admissions. RESULTS: At univariate and multivariate analyses, AF lasting less than 48 h, absence of comorbidities and younger age were independent predictors of sinus rhythm; conversely, lack of sinus rhythm, older age, AF lasting more than 48 h and comorbidities were independent predictors of hospitalization. Overall, 55% of patients achieved sinus rhythm in group 1 versus 62% in group 2 (p=0.018). Interestingly, in patients with AF lasting less than 48 h, 89% achieved sinus rhythm, more likely by class 1C than by class III antiarrhythmic drugs (p<0.001). Overall reduction of admission accounts for 60%; 50% of patients need admission in group 1 versus 29% in group 2 (p<0.001). CONCLUSIONS: Aggressive pharmacological and electrical approach in patients presenting AF and hypertension significantly improved rhythm conversion overall up to 62%. Patients with AF lasting less than 48 h eventually achieved sinus rhythm up to 89%, mostly by class IC antiarrhythmic drugs. Admissions eventually reduced up to 60%.[Abstract] [Full Text] [Related] [New Search]