Cardiac Denervation After Radiofrequency Ablation of Supraventricular Tachycardias

Heart Rate Variability and Atria Function in Children at Late Follow-Up Evaluation After Atrioventricular Node Slow-Pathway Radiofrequency Ablation

“…In contrast to previous studies, which have shown changes immediately or the next day after RFA [14, 16, 19, 21], we found the changes in autonomic tone of the heart during the late follow-up period. Only two other studies have demonstrated changes in autonomic tone during a 6-month to 1-year follow-up period after accessory pathways and AV node slow-pathway RFA [8, 10].…”

“…Thus, parasympathetic denervation may be an explanation for the increased HR and inappropriate sinus tachycardia in these children. Experimental studies have shown that parasympathetic reinnervation usually requires only 6 weeks (in dogs) [14, 16]. The possible explanation for the long-term changes in the autonomic tone after RFA may be a more pronounced lesion of RFA in a child heart, which is smaller and has thinner walls more vulnerable to injury.…”

Morphology, distribution, and variability of the epicardiac neural ganglionated subplexuses in the human heart

“…The intrinsic cardiac nervous system influences cardiac rate, atrial and ventricular refractoriness, coronary blood flow, valvular function, and atrial natriuretic peptide secretion, and appears to be involved in the development of risky disorders of the human heart (Neely and Urthaler, 1992; Gulbenkian et al, 1993; Oki et al, 1994; Bernardi et al, 1994; van de Borne et al, 1994; Ehlert et al, 1994; Zabel et al, 1994; Esler et al, 1995; Baumgart and Heusch, 1995; Schuessler et al, 1996; Zucker, 1996; Chiou and Zipes, 1998; Beaulieu and Lambert, 1998; Stevens et al, 1998; Wen et al, 1998; Armour, 1999). Intrinsic neural pathways appear to be important in radiofrequency ablation of both supraventricular and atrioventricular nodal reentrant tachycardia because preganglionic and postganglionic nerve fibers disrupted in this way may be the determinant in occurrence of serious postsurgery complications, including complete atrioventricular block, ventricular fibrilation, and sudden death (Kocovic et al, 1993; Strickberger et al, 1996; Gaita et al, 1998; Psychari et al, 1998; Jinbo et al, 1998; Uchida et al, 1998). In human cardiac transplantation, the role of intracardiac nerves in the improvement of exercise capacity after transplantation and the development of coronary artery disease and arrhythmias is also considerable since heart transplantation failures may be chiefly associated both with cardiac denervation and reinnervation after cardiac transplantation (Mason et al, 1976; Fallen et al, 1988; Bernardi et al, 1994; Ramaekers et al, 1996; Constant et al, 1995; Armour, 1999; Bengel et al, 1999).…”

Effects of Linear Ablation at the Isthmus Between the Tricuspid Annulus and Inferior Vena Cava for Atrial Flutter on Autonomic Nervous Activity

“…8 Since their study, it has been observed that heart rate increases and heart rate variability decreases after the ablation of the fast atrioventricular nodal pathway, 8,9,12 slow atrioventricular nodal pathway, 9,12,14,16,19,28 left free wall accessory pathway, 14 right free wall accessory pathway, 16 and the attenuation of vagal indices of heart rate variability. These investigators have speculated that autonomic dysfunction might play an important role in its mechanism.…”

“…Recently, heart rate variability has been used widely to reflect the autonomic nervous system (sympathetic and parasympathetic) activity on the sinus node. [8][9][10][11][12][13][14][15][16][19][20][21] Therefore, the purpose of the present study was to evaluate the effects of linear ablation of the cavotricuspid isthmus on the autonomic nervous function of the sinus node using heart rate variability analysis, and to investigate the distribution of efferent autonomic nervous fibers in the human heart.…”