SMAC-AF Trial

Acronym: Atrial Substrate Modification with Aggressive Blood Pressure Lowering to Prevent AF

Purpose: Researchers analyzed whether aggressive blood pressure lowering reduces risk for recurrent atrial fibrillation after catheter ablation

Format: Randomized, open-label, parallel-assignment

Treatment Group: Aggressive treatment

Control Group: Standard treatment

Number of Participants: 184

Centers: 13

Summary: At 6 months, systolic blood pressure was lower in the aggressive-treatment group vs. 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 atrial fibrillation, 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 blood pressure treatment was more likely to benefit those older than 61 years (P for interaction = .013) and those with baseline systolic blood pressure < 140 mm Hg (P for interaction = .022).

Link to Cardiology Today Article:

https://www.healio.com/cardiology/arrhythmia-disorders/news/online/%7be203d050-ab73-413c-967e-afe5e7d4b7de%7d/smac-af-atrial-arrhythmias-not-reduced-with-aggressive-bp-treatment