For older adults with high blood pressure and atrial fibrillation (AFib), a combination of two blood pressure medications may significantly reduce the risk of recurring irregular heart rhythms after an ablation procedure, according to preliminary research presented at the American Heart Association's Scientific Sessions 2026.
The randomized clinical trial, conducted at three hospitals in China, followed 320 patients aged 55 and older who underwent catheter ablation for AFib. After the procedure, participants were randomly assigned to receive either a combination of sacubitril and valsartan (100 mg once daily) or valsartan alone (80 mg once daily). Over a 12-month follow-up period, the combination therapy was associated with a lower rate of documented AFib or related atrial arrhythmias compared to the single medication.
Specifically, recurrent atrial tachyarrhythmias occurred in 18% of participants in the sacubitril/valsartan group versus 28.3% in the valsartan-only group. Notably, systolic blood pressure decreased by about 10 mm Hg in both groups, with no significant difference in 24-hour ambulatory blood pressure reduction. This suggests that the benefit of the combination therapy may not be 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. "What was particularly interesting to us was that the difference in AFib recurrence was observed even though blood pressure reductions were similar between the two groups."
The study's results could have significant implications for the management of AFib patients with hypertension. AFib is a common heart rhythm disorder that can lead to symptoms such as palpitations, shortness of breath, and fatigue, and it increases the risk of stroke and heart failure. Ablation is an effective treatment, but recurrence rates remain high, often necessitating repeat procedures or additional medications. The findings hint that the type of blood pressure medication used after ablation may matter as much as the degree of blood pressure reduction.
However, the researchers caution that the study is preliminary and has limitations. It was an open-label trial, and heart rhythm monitoring was intermittent, so some asymptomatic episodes may have been missed. 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.
The research was supported by grants from the National Natural Science Foundation of China, the Ministry of Science and Technology of China, and Shanghai municipal research programs. The full abstract is available in the American Heart Association's Online Program Planner for Scientific Sessions 2026. For more information on AFib and its treatment, visit the American Heart Association's Diagnosis and Treatment of Atrial Fibrillation page. Additional resources on stroke risk and AFib are available through the Association's newsroom, including a release on how Ablation reduces stroke risk for AFib and may remove need for some types of blood thinners.
