Journal of Clinical Medicine Research

Objective: This study aimed to investigate the Holter ECG characteristics of patients with hypertension complicated by paroxysmal atrial fibrillation and to analyse their association with postoperative arrhythmia recurrence. Methods: A retrospective cohort study was conducted on 230 patients with hypertension complicated by paroxysmal atrial fibrillation (PAF) treated at the Electrocardiography Department of Yichang Central People's Hospital between July 2023 and December 2024. Patients were categorised into a recurrence group (n=48) and a non-recurrence group (n=182) based on postoperative recurrence status. Preoperative 24-hour Holter monitoring data were collected for all patients. Univariate analysis compared clinical characteristics between groups, whilst multivariate logistic regression identified risk factors for postoperative recurrence. Results: Univariate analysis revealed that patients in the recurrence group exhibited significantly higher values for BMI, LAD, ultra-low frequency power, low-frequency power, and heart rate deceleration capacity compared to the non-recurrence group, while high-frequency power, rMSSD, pNN50, and SDNN were significantly lower (P < 0.05). Multivariate logistic regression analysis identified heart rate deceleration capacity, SDNN, and LAD as independent risk factors for postoperative recurrence in hypertensive patients with PAF (P < 0.05). Conclusion: Quantitative parameters of Holter monitoring in patients with hypertension complicated by PAF exhibit characteristic alterations, with reductions observed in high-frequency power, rMSSD, pNN50, and SDNN. Heart rate deceleration capacity, SDNN, and LAD constitute independent risk factors for recurrence following radiofrequency ablation.