Individualized weighing of the risk benefit of anticoagulation is recommended in patients with atrial fibrillation (AF) who have low established risk scores or, conversely, are at increased risk for bleeding. Parameters of arterial stiffness and wave reflection could improve risk stratification, but their use has not been evaluated in arrhythmia. We measured carotid-femoral pulse wave velocity (PWV), central augmentation index (AI), and central pulse pressure (CPP) using the SphygmoCor system in 34 patients (53 to 85 years; 25 males) with AF before and after elective electrical cardioversion. Agreement was assessed using the intraclass correlation coefficient (ICC) and the coefficient of variation, completed with Bland–Altman plots. After cardioversion, mean arterial blood pressure (MAP) and heart rate (HR) decreased significantly by 8 mmHg and 18 bpm, respectively. PWV decreased from 11.8 m/s to 10.7 m/s, AI increased from 24% to 29%, and CPP rose from 38 mmHg to 43 mmHg. The decrease in PWV was related to the decrease in MAP (beta = 0.57; R² = 0.33; P < .001), whereas changes in AI and CPP were related to the decrease in HR (AI: beta = −0.59; R² = 0.35; P < .001, CPP: beta = −0.55; R² = 0.28; P = .001). After adjustment for changes in MAP and HR, reliability analysis showed an excellent agreement for PWV (ICC = 0.89; 95% confidence interval (CI): 0.79–0.95) but moderate agreement for AI (ICC = 0.59; 95% CI: 0.17–0.80). Excellent agreement was also found for CPP (ICC = 0.89; 95% CI: 0.72–0.95). Measurement of PWV and CPP is reliable in patients with AF, as they appear unaffected by the presence of arrhythmia.

对于房颤（AF），既定风险评分低或出血风险增加的患者，建议对抗凝风险获益进行个体化评估。动脉僵硬度和波反射参数可以改善风险分层，但尚未在心律不齐中评估其使用。我们使用SphygmoCor系统测量了择期电复律前后AF患者的颈股脉搏波速度（PWV），中枢增强指数（AI）和中枢脉压（CPP），共34例（53至85岁；男25例） 。使用类内相关系数（ICC）和变异系数（通过Bland–Altman图完成）评估一致性。复律后，平均动脉压（MAP）和心率（HR）分别显着降低了8 mmHg和18 bpm。PWV从11.8 m / s下降到10.7 m / s，AI从24％上升到29％，CPP从38 mmHg上升到43 mmHg。PWV的降低与MAP的降低有关（β= 0.57； R²  = 0.33；P  <.001），而AI和CPP的变化与HR降低有关（AI：beta = -0.59; R ²  = 0.35; P  <.001，CPP：beta = -0.55; R ²  = 0.28; P  = .001）。调整MAP和HR的变化后，可靠性分析显示PWV的一致性很好（ICC = 0.89； 95％置信区间（CI）：0.79–0.95），而AI的一致性良好（ICC = 0.59; 95％CI：0.17– 0.80）。对于CPP，也发现了极好的一致性（ICC = 0.89； 95％CI：0.72-0.95）。AF患者中PWV和CPP的测量是可靠的，因为它们似乎不受心律不齐的影响。