Alterations of heart rate and of heart rate variability after radiofrequency catheter ablation of supraventricular tachycardia. Delineation of parasympathetic pathways in the human heart.

Kocovic, Dusan Z.; Harada, Tomoo; Shea, Julie B.; Soroff, D

doi:10.1161/01.cir.88.4.1671

Cited by 105 publications

(84 citation statements)

References 22 publications

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“…1-6,16 -19 In the present study, the prevalence of inappropriate sinus tachycardia was 6.7%, similar to that in previous reports regarding ablation of supraventricular tachycardias. [1][2][3]17,18 We also found decreases in SDRR, rMSSD, and HF and increases in mean and maximal sinus rate and LF/HF ratio, which indicates autonomic dysfunction, just like the findings after ablation of supraventricular tachycardias. Furthermore, no significant changes in HR and HRV were noted in our control group, which indicates autonomic dysfunction after ablation of PVs was not related to the transseptal procedure.…”

Section: Autonomic Dysfunction After Ablation Of Pvssupporting

confidence: 72%

“…[1][2][3][4][5][6] Therefore, we performed 24-hour Holter monitoring at 1 and 6 months after ablation of PVs, respectively, to see the chronic changes in HRV. The results showed that an increase in HR and a decrease in HRV recovered at 1 month after ablation of PVs, indicating a transient dysfunction of autonomic nervous system, just as the findings after ablation of supraventricular tachycardias.…”

Section: Recovery Of Autonomic Dysfunction After Ablation Of Pvsmentioning

confidence: 99%

“…[1][2][3][4][5][6] Several reports have demonstrated an increase in heart rate (HR) and a decrease in HR variability (HRV) after ablation of slow atrioventricular nodal, posteroseptal, and para-hisian accessory pathways. [2][3][4][5][6] These reports suggested that transient parasympathetic nervous withdrawal might be one of the mechanisms that causes these HR effects when RF energy is applied around these pathways. Recently, RF catheter ablation of pulmonary veins (PVs) has been demonstrated to cure focal atrial fibrillation (AF).…”

mentioning

confidence: 99%

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Alterations of Heart Rate Variability After Radiofrequency Catheter Ablation of Focal Atrial Fibrillation Originating From Pulmonary Veins

et al. 1999

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Background-Transient sinus bradycardia and hypotension have been reported as complications during radiofrequency (RF) ablation of focal atrial fibrillation (AF) originating from pulmonary veins (PVs). This study used heart rate variability (HRV) to evaluate the effects of focal PVs ablation on autonomic function. Methods and Results-Thirty-seven patients with paroxysmal AF were referred for ablation. The study group included 30 patients who underwent transseptal ablation of PVs, and the control group included 7 patients who underwent the transseptal procedure without ablation. The mean sinus rate and time-domain (standard deviation of RR intervals and root-mean-square of differences of adjacent RR intervals) and frequency-domain (low frequency, high frequency, and low-frequency/high-frequency ratio) analyses of HRV were obtained by use of 24-hour Holter monitoring before and 1 week, 1 month, and 6 months after ablation. All the triggering points of AF were from PVs, and they were successfully ablated. Severe bradycardia and hypotension were noted during ablation of PVs in 6 patients (group IA); 24 patients without the above complication belonged to group IB. Compared with preablation values, a significant increase in mean sinus rate and low-frequency/high-frequency ratio and a significant decrease in standard deviation of RR intervals, root-mean-square of differences of adjacent RR intervals, low frequency, and high frequency were noted in groups IA and IB patients 1 week after ablation. The changes in HR and HRV recovered spontaneously in the 2 subgroups by 1 month later. These parameters of HRV did not change in the control group after the transseptal procedure. Conclusions-Transient autonomic dysfunction with alterations in HR and HRV occurred after ablation of focal AF

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Section: Autonomic Dysfunction After Ablation Of Pvssupporting

confidence: 72%

Section: Recovery Of Autonomic Dysfunction After Ablation Of Pvsmentioning

confidence: 99%

mentioning

confidence: 99%

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Alterations of Heart Rate Variability After Radiofrequency Catheter Ablation of Focal Atrial Fibrillation Originating From Pulmonary Veins

et al. 1999

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“…25 Indirect effects related to the procedure could play a role in the early onset of atrial fibrillation in some patients. Disturbances of autonomic function are common in the initial weeks after radiofrequency ablation of the posterior septum, 26 most commonly loss of parasympathetic tone. However, parasympathetic denervation associated with ablation may potentially reduce the risk of atrial fibrillation, as recently reported in an animal model autonomically mediated atrial fibrillation.…”

Section: Role Of the Ablation Proceduresmentioning

confidence: 99%

Atrial Fibrillation After Radiofrequency Ablation of Type I Atrial Flutter

et al. 1998

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Background-The occurrence of atrial fibrillation after ablation of type I atrial flutter remains an important clinical problem. To gain further insight into the pathogenesis and significance of postablation atrial fibrillation, we examined the time to onset, determinants, and clinical course of atrial fibrillation after ablation of type I flutter in a large patient cohort. Methods and Results-Of 110 consecutive patients with ablation of type I atrial flutter, atrial fibrillation was documented in 28 (25%) during a mean follow-up of 20.1Ϯ9.2 months (cumulative probability of 12% at 1 month, 23% at 1 year, and 30% at 2 years). Among 17 clinical and procedural variables, only a history of spontaneous atrial fibrillation (relative risk 3.9, 95% confidence intervals 1.8 to 8.8, Pϭ0.001) and left ventricular ejection fraction Ͻ50% (relative risk 3.8, 95% confidence intervals 1.7 to 8.5, Pϭ0.001) were significant and independent predictors of subsequent atrial fibrillation. The presence of both these characteristics identified a high-risk group with a 74% occurrence of atrial fibrillation. Patients with only 1 of these characteristics were at intermediate risk (20%), and those with neither characteristic were at lowest risk (10%). The determinants and clinical course of atrial fibrillation did not differ between an early (Յ1 month) compared with a later onset. Atrial fibrillation was persistent and recurrent, requiring long-term therapy in 18 patients, including 12 of 19 (63%) with prior atrial fibrillation and left ventricular dysfunction. Conclusions-Atrial fibrillation after type I flutter ablation is primarily determined by the presence of a preexisting structural and electrophysiological substrate. These data should be considered in planning postablation management. The persistent risk of atrial fibrillation in this population also suggests a potentially important role for atrial fibrillation as a trigger rather than a consequence of type I atrial flutter. (Circulation. 1998;98:315-322.)

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“…Fluctuations in autonomic tone have also been documented in patients (n = 28) five minutes prior to onset of atrial fibrillation with episodes (n =18) of abrupt decrease in LF and increase in HF consistent with increased parasympathetic tone (p < .001) and episodes (n = 18) of abrupt increase in LF and decrease in HF consistent with increased sympathetic dominance (p = .004) (Fioranelli et al, 1999), or similarly, a sudden drop in SDNN and increase in LF/HF ratio six minutes prior to onset of atrial flutter (n = 12) (Wen, Chen, Tai, Huang, & Cheang, 1998). Decrease in HF following ablation and resumption of HF levels one to six months later suggests altered autonomic tone within cardiac nerve receptors (Kocovic, Harada, Shea, Soroff, & Friedman, 1993). Expression of arrhythmia conduction may also depend on individual intrinsic conduction pathways (Bissett, de Soyza, Kane, & Murphy, 1976).…”

Section: Heart Rate Variability and Physical Factorsmentioning

confidence: 97%

Military Sexual Trauma Exposure and Heart Rate Variability Outcomes in Female Veterans

Lee¹

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DEDICATIONThis dissertation is dedicated to God, who opened my eyes, ears and heart to the abuse and suffering of women everywhere, including my Aunt Ethel who suffered at the hands of her husband when I was a child; my friend and former nursing student Micah, who died from her injuries; and all those abused that I cared for in numerous hospitals, clinics, and shelters through the years. I want to especially acknowledge the sacrifice made by the veterans who experienced military sexual trauma while serving our country.iv ACKNOWLEDGEMENTS

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Alterations of heart rate and of heart rate variability after radiofrequency catheter ablation of supraventricular tachycardia. Delineation of parasympathetic pathways in the human heart.

Cited by 105 publications

References 22 publications

Alterations of Heart Rate Variability After Radiofrequency Catheter Ablation of Focal Atrial Fibrillation Originating From Pulmonary Veins

Alterations of Heart Rate Variability After Radiofrequency Catheter Ablation of Focal Atrial Fibrillation Originating From Pulmonary Veins

Atrial Fibrillation After Radiofrequency Ablation of Type I Atrial Flutter

Military Sexual Trauma Exposure and Heart Rate Variability Outcomes in Female Veterans

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