For older adults with high blood pressure and atrial fibrillation (AFib), the choice of blood pressure medication after an ablation procedure may significantly influence the likelihood of the irregular heart rhythm returning, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2026.
The randomized trial, conducted at three hospitals in China, followed 320 patients who underwent catheter ablation for AFib. After the procedure, participants were randomly assigned to receive either a combination of sacubitril and valsartan or valsartan alone. Over 12 months, documented recurrence of AFib or related atrial arrhythmias occurred in 18% of the combination group compared to 28.3% in the valsartan-only group. Notably, both groups experienced similar reductions in blood pressure—about 10 mm Hg in systolic pressure—suggesting that the difference in recurrence was not solely due to blood pressure lowering.
“Our findings reinforce the idea that treating AFib does not end with the ablation procedure, and managing hypertension remains an important part of comprehensive AFib care,” said lead author Wei Zhang, M.D., Ph.D., a cardiologist at the Shanghai Institute of Hypertension at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. “The type of treatment used to lower blood pressure may be as important as how much blood pressure is lowered.”
AFib is a common heart rhythm disorder that can cause symptoms such as palpitations, shortness of breath, and fatigue, and it increases the risk of stroke and heart failure. Ablation is an effective rhythm-control strategy, but recurrence remains a challenge, often necessitating additional procedures or medication adjustments. The study’s findings point to a potential strategy for improving long-term outcomes by targeting the underlying structural heart changes that predispose to AFib.
The researchers note several limitations: the trial was open-label, meaning patients and doctors knew which treatment was given, and heart rhythm monitoring was intermittent, so some asymptomatic episodes may have been missed. Additionally, the findings may not apply to younger adults, those without hypertension, or populations outside China. The results are considered preliminary until published in a peer-reviewed journal.
For patients and clinicians, the study underscores the importance of comprehensive post-ablation care that addresses both rhythm control and cardiovascular risk factors. As Zhang noted, “AFib is a complex condition, and successful long-term management requires both effective rhythm treatment and careful management of underlying cardiovascular risk factors, particularly hypertension.” The research was supported by grants from the National Natural Science Foundation of China and other Chinese institutions. Detailed findings are available in the abstract and the Online Program Planner.
