Aortic Stiffness in Lone Atrial Fibrillation A Novel Risk Factor for Arrhythmia Recurrence.docVIP

Aortic Stiffness in Lone Atrial Fibrillation: A Novel Risk Factor for Arrhythmia Recurrence Dennis H. Lau , Martin K. Stiles R. Willoughby , Glenn D. Young 1 , Melissa E. Middeldorp 1 , Anthony G. Brooks 1 , Anand N. Ganesan , Han S. Lim , Christopher X. Wong , Walter P. Abhayaratna , Prashanthan Sanders 1* 1 , Kurt C. Roberts- Thomson 1 1 , Darryl P. Leong 1 , Hany S. Abed 1 1 1 , Scott 1 1 , Jonathan M. Kalman 2 3 1 Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia, 2 Department of Cardiology, Royal Melbourne Hospital and the Department of Medicine, University of Melbourne, Victoria, Australia, 3 Academic Unit of Internal Medicine, Canberra Hospital, Canberra, Australia Abstract Background: Recent community-based research has linked aortic stiffness to the development of atrial fibrillation. We posit that aortic stiffness contributes to adverse atrial remodeling leading to the persistence of atrial fibrillation following catheter ablation in lone atrial fibrillation patients, despite the absence of apparent structural heart disease. Here, we aim to evaluate aortic stiffness in lone atrial fibrillation patients and determine its association with arrhythmia recurrence following radio-frequency catheter ablation. Methods: We studied 68 consecutive lone atrial fibrillation patients who underwent catheter ablation procedure for atrial fibrillation and 50 healthy age- and sex-matched community controls. We performed radial artery applanation tonometry to obtain central measures of aortic stiffness: pulse pressure, augmentation pressure and augmentation index. Following ablation, arrhythmia recurrence was monitored at months 3, 6, 9, 12 and 6 monthly thereafter. Results: Compared to healthy controls, lone atrial fibrillation patients had significantly elevated peripheral pulse pressure, central pulse pressure, augmentation pressure and large