BLOOD PRESSURE MEASUREMENTS COMPARISON BY AUSCULTATION AND OSCILLOMETRIC METHODS IN PATIENTS WITH ATRIAL FIBRILLATION AND ARTERIAL HYPERTENSION
G. Marinskis, A. Selmyte, J. Barysiene, D. Petrikonyte, J. Alunderyte, P. Narusis, A. Aidietis
Clinic of Cardiovascular diseases, Vilnius University, Vilnius, Lithuania
Aim: To evaluate the difference between two methods during sinus rhythm and atrial fibrillation (AF).
Case: An 81-year-old man complained of palpitation because of narrow QRS short RP tachycardia (CL 550ms) was referred for EPS/ablation. The ECG during sinus rhythm showed normal PQ interval and narrow QRS complex. During EPS study, his AH and HV intervals were 132ms and 57ms, respectively. RV pacing showed no VA conduction. Programmed atrial stimulation revealed dual-AV node physiology. No tachycardia was inducible without isoproterenol. However, after intravenous administration of isoproterenol, two ventricular responses (1:2 AV conduction pattern) were occurred spontaneously and induced by rapid atrial stimulation. The first AH interval was 77 ms and that second was 645ms. After the two ventricular responses, sinus tachycardia with perpetuating slow pathway conduction (AH 360ms) mimicked short RP tachycardia. Single atrial extra-stimulation just before His potential advanced the next His potential and atrial tachycardia with fast pathway conduction was resumed (peel back phenomenon).
Methods: Blood pressure (BP) was measured and compared in 71 randomly selected patients with AF and AH diagnosis 4 times each by auscultation and oscillometric (Microlife AFib A6 PC) methods.
Results: Study included 36 males (mean age 67.36yrs), 35 females (70.17yrs). In sinus rhythm (SR) were 36, 35 patients in AF. Adjusted office BP (<140/90mmHg) was in 66.2% patients measuring by auscultation method (AM) and in 54.9% with oscillometric method (OM). The significant difference in BP (> 7 mmHg) measured in SR group was in 28 patients, in AF group - 22 patients. In SR patients mean systolic blood pressure (SBP) was 132±17.9mmHg (AM), 137.4±19.4mmHg (OM); diastolic BP 77.1±10.9mmHg (AM), 78.5±12.2mmHg (OM), during AF patients 127.5±15.1mmHg (AM), 133.6±17.4mmHg (OM); DBP 81.4±9.9mmHg (AM), 83.5±11.8mmHg (OM), p=0.037.
Conclusions: Oscillometric method gave higher BP values in both patient groups. Higher difference between four systolic blood pressure measurements was found in sinus rhythm patient group.
