SMAC-AF Trial

The Atrial Substrate Modification with Aggressive Blood Pressure Control to Prevent AF trial analyzed whether aggressive BP lowering reduces risk for recurrent atrial fibrillation after catheter ablation for AF.

Design: Randomized, open-label, parallel assignment

Patients: 184

Centers: 13

CountrY: Canada

Results: At 6 months, systolic BP was lower in the aggressive-treatment group than in the standard-treatment group (132.2 mm Hg vs. 135.4 mm Hg; P < .001), but there was no difference in the primary outcome of time to symptomatic AF, atrial tachycardia or atrial flutter lasting over 30 seconds more than 3 months after ablation (HR = 0.94; 95% CI, 0.65-1.38). Aggressive BP treatment was more likely to benefit those over age 61 years (P for interaction = .013) and those with baseline systolic BP < 140 mm Hg (P for interaction = .022).

Original Publication:
Parkash R, et al. Circulation. 2017;doi.org/10.1161/CIRCULATIONAHA.116.026230

Healio/Cardiology News Coverage:
SMAC-AF: Atrial arrhythmias not reduced with aggressive BP treatment