scholarly journals Response by Parkash et al to Letters Regarding Article, “Effect of Aggressive Blood Pressure Control on the Recurrence of Atrial Fibrillation After Catheter Ablation: A Randomized, Open-Label Clinical Trial (SMAC-AF [Substrate Modification With Aggressive Blood Pressure Control])”

Circulation ◽  
2017 ◽  
Vol 136 (13) ◽  
pp. 1271-1272
Author(s):  
Ratika Parkash ◽  
John L. Sapp ◽  
Jeff S. Healey ◽  
Anthony S.L. Tang
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Clinical Trial ◽  
Catheter Ablation ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Open Label ◽  
Substrate Modification

scholarly journals The role of brain natriuretic peptide in atrial fibrillation: a substudy of the Substrate Modification with Aggressive Blood Pressure Control for Atrial Fibrillation (SMAC-AF) trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Willy Weng ◽  
Rajin Choudhury ◽  
John Sapp ◽  
Anthony Tang ◽  
Jeff S. Healey ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Catheter Ablation ◽  
Blood Pressure Control ◽  
Primary Outcome ◽  
Pressure Control ◽  
Standard Group ◽  
Substrate Modification ◽  
Af Recurrence

Abstract Background Catheter ablation is an established therapy for atrial fibrillation but is limited by recurrence; efforts have been made to identify biomarkers that predict recurrence. We investigated the effect of baseline NT-proBNP on AF recurrence following catheter ablation in patients randomized to aggressive (< 120/80 mmHg) or standard blood pressure management (< 140/90 mmHg) in the Substrate Modification with Aggressive Blood Pressure Control trial (SMAC-AF). Methods The SMAC-AF study included 173 patients resistant or intolerant to at least one class I or III antiarrhythmic drug. We studied the effect of baseline NT-proBNP on the primary outcome of AF recurrence > 3 months post-ablation. Results Of the 173 patients, 88 were randomized to the aggressive cohort, and 85 into the standard group. The primary outcome occurred in 61.4% of those in the aggressive arm, versus 61.2% in the standard arm. In the aggressive group, logNT-proBNP predicted recurrence (HR 1.28, p = 0.04, adjusted HR 1.43, p = 0.03), while in the standard cohort, it did not (HR 0.94, p = 0.62, adjusted HR 0.83, p = 0.22). NT-proBNP ≥ 280 pg/mL also predicted occurrence in the aggressive (HR 1.98, p = 0.02) but not the standard cohort (HR 1.00, p = 1.00). Conclusion We conclude that pre-ablation NT-proBNP may be useful in predicting recurrence in hypertensive patients and identifying patients who benefit from aggressive blood control and upstream therapies. Trial registration: NCT00438113, registered February 21, 2007.

scholarly journals Effect of Aggressive Blood Pressure Control on the Recurrence of Atrial Fibrillation After Catheter Ablation

Circulation ◽  
2017 ◽  
Vol 135 (19) ◽  
pp. 1788-1798 ◽  
Author(s):  
Ratika Parkash ◽  
George A. Wells ◽  
John L. Sapp ◽  
Jeffrey S. Healey ◽  
Jean-Claude Tardif ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Catheter Ablation ◽  
Blood Pressure Control ◽  
Pressure Control
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