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;

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