Zang Xiaobiao, Zhao Zhihan, Chen Ke, Song Weifeng, Ma Jifang, Zhou You, Liang Erpeng, Fu Haixia, Wang Xianqing, Zhao Yonghui, Zhang Rongfeng
Department of Cardiology, People's Hospital of Zhengzhou University (Henan Provincial People's Hospital), Fuwai Central China Cardiovascular Hospital, No. 1 Fuwai Avenue, Zhengdong New District, Zhengzhou City, 451400, Henan Province, China.
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Cardiovasc Drugs Ther. 2025 Feb;39(1):97-106. doi: 10.1007/s10557-023-07493-6. Epub 2023 Sep 7.
To evaluate whether the effect of radiofrequency ablation can be improved by using sacubitril/valsartan (S/V) to control blood pressure in hypertensive patients with persistent atrial fibrillation.
A total of 63 and 67 hypertension patients with persistent atrial fibrillation were enrolled in an S/V group and ACEI/ARB group, respectively. All patients underwent radiofrequency catheter ablation (RFCA). The blood pressure of the two groups was controlled within the range of 100-140 mmHg (high pressure) and 60-90 mmHg (low pressure). The clinical outcomes of the two groups were observed after 12 months of follow-up.
No significant differences in blood pressure were observed between the S/V and ACEI/ARB groups. In addition, the recurrence rate of atrial fibrillation between the two groups was not different. The left atrial diameter was an independent predictor of recurrence (HR = 1.063, P = 0.008). However, in the heart failure subgroup, the recurrence rate of S/V was significantly lower than that of the ACEI/ARB group (P = 0.005), and Cox regression analysis showed that the recurrence risk of atrial fibrillation of the S/V group was 0.302 lower than that of the ACEI/ARB group. NT-proBNP, LVEF, and LAD were significantly improved in hypertension patients with heart failure when comparing cases before and at the end of follow-up.
S/V is better than ACEI/ARB in reducing the recurrence of persistent atrial fibrillation in patients with hypertension and heart failure after RFCA.
评估在持续性心房颤动的高血压患者中使用沙库巴曲缬沙坦（S/V）控制血压是否能提高射频消融的效果。
分别将63例和67例持续性心房颤动的高血压患者纳入S/V组和ACEI/ARB组。所有患者均接受射频导管消融（RFCA）。两组血压控制在100 - 140 mmHg（高压）和60 - 90 mmHg（低压）范围内。随访12个月后观察两组的临床结局。
S/V组和ACEI/ARB组之间血压无显著差异。此外，两组之间心房颤动的复发率无差异。左心房直径是复发的独立预测因素（HR = 1.063，P = 0.008）。然而，在心力衰竭亚组中，S/V组的复发率显著低于ACEI/ARB组（P = 0.005），Cox回归分析显示S/V组心房颤动的复发风险比ACEI/ARB组低0.302。比较随访前和随访结束时的病例，心力衰竭高血压患者的NT - proBNP、LVEF和LAD有显著改善。
在射频消融术后，S/V在降低高血压合并心力衰竭患者持续性心房颤动复发方面优于ACEI/ARB。
