The short‐term impact of the catheter ablation on noninvasive autonomic nervous system parameters in patients with paroxysmal atrial fibrillation

Kuyumcu, Mevlüt Serdar; Özeke, Özcan; Çay, Serkan; Özcan, Fırat; Bayraktar, Muhammed Fatih; Kara, Meryem; Vicdan, Murat; Acar, Berrin; Aydoğdu, Sinan; Topaloğlu, Serkan; Aras, Dursun

doi:10.1111/pace.13179

Cited by 12 publications

(5 citation statements)

References 62 publications

(131 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a prospective study, Kuyumcu, et al [19] documented an increase of RHR after cryoballon PVI for paroxysmal AF. No difference in the degree of RHR increase was noted in patients with and without recurrence in the 3-month follow-up period.…”

Section: Discussionmentioning

confidence: 97%

Is Increased Resting Heart Rate after Radiofrequency Pulmonary Vein Isolation a Predictor of Favorable Long-Term Outcome of the Procedure?

Maciejewski

Peller

Lodziński

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Increased resting heart rate (RHR) after pulmonary vein isolation (PVI) for treatment of atrial fibrillation (AF) is a common observation, possibly resulting from ganglionated plexus modification during ablation. Previous trials have suggested that an increase in RHR after ablation might be related to higher efficacy of the procedure. The aim of this study was to determine whether or not higher increase in RHR after radiofrequency (RF) PVI might predict better long-term outcome of the procedure in a real-life cohort of patients in whom index ablation for paroxysmal AF was performed. Material and methods: The health records of patients who underwent index point-by-point or drag lesion RF PVI for paroxysmal AF in our department between January 2014 and November 2018 were analyzed. Resting heart rate (RHR) was determined from 12-lead ECG recorded prior to the ablation and before discharge to evaluate changes in RHR after PVI. Only patients in sinus rhythm before the procedure and at discharge were included in the analysis. Telephone follow-up was collected for evaluation of arrhythmia recurrence status. Results: A total of 146 patients who underwent PVI for paroxysmal AF were included. Mean follow-up time was 3.5 years. RHR increased from 64 [58.5–70], prior to procedure, to 72 [64.25–80] bpm at discharge (p < 0.001). Higher increase in RHR was not protective from arrhythmia recurrence in long-term observation in both univariable HR = 1.001 (CI 0.99–1.017, p = 0.857) and multivariable analyses HR = 1.001 (CI 0.99–1.02, p = 0.84). Conclusions: RHR after PVI increased in comparison to baseline in our cohort. However, we did not observe higher increase in RHR to be associated with more favorable long-term effectiveness of the procedure.

show abstract

Section: Discussionmentioning

confidence: 97%

Is Increased Resting Heart Rate after Radiofrequency Pulmonary Vein Isolation a Predictor of Favorable Long-Term Outcome of the Procedure?

Maciejewski

Peller

Lodziński

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Currently, exercise performance [48] in patients with AF following catheter ablation has not been fully explored: On the one hand, in patients with longstanding asymptomatic persistent AF catheter ablation improved exercise performance [49]. On the other hand, HR recovery as well as chronotropic reserve has been found to be reduced in patients with paroxysmal AF for at least up to 3 months after PVI [50]. One might speculate that the latter is linked to reduced exercise performance even after successful restoration of sinus rhythm, especially considering our findings.…”

Section: Discussionmentioning

confidence: 99%

Respiratory sinus arrhythmia is reduced after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

Jungen¹,

Alken²,

Scherschel³

et al. 2020

aoms

View full text Add to dashboard Cite

Introduction: Respiratory sinus arrhythmia (RSA) describes heart rate (HR) changes in synchrony with respiration. It is relevant for exercise capacity and mechanistically linked with the cardiac autonomic nervous system. After pulmonary vein isolation (PVI), the current therapy of choice for patients with paroxysmal atrial fibrillation (AF), the cardiac vagal tone is often diminished. We hypothesized that RSA is modulated by PVI in patients with paroxysmal AF. Material and methods: Respiratory sinus arrhythmia, measured by using a deep breathing test and heart rate variability parameters, was studied in 10 patients (64 ±3 years) with paroxysmal AF presenting in stable sinus rhythm for their first catheter-based PVI. Additionally, heart rate dynamics before and after PVI were studied during sympathetic/parasympathetic coactivation by using a cold-face test. All tests were performed within 24 h before and 48 h after PVI. Results: After PVI RSA (E/I difference: 7.9 ±1.0 vs. 3.5 ±0.6 bpm, p = 0.006; E/I ratio: 1.14 ±0.02 vs. 1.05 ±0.01, p = 0.003), heart rate variability (SDNN: 31 ±3 vs. 14 ±3 ms, p = 0.006; RMSSD: 17 ±2 vs. 8 ±2 ms, p = 0.002) and the HR response to sympathetic/parasympathetic coactivation (10.2 ±0.7% vs. 5.7 ±1.1%, p = 0.014) were diminished. The PVI-related changes in RSA correlated with the heart rate change during sympathetic/parasympathetic coactivation before vs. after PVI (E/I difference: r = 0.849, p = 0.002; E/I ratio: r = 0.786, p = 0.007). One patient with vagal driven arrhythmia experienced AF recurrence during follow-up (mean: 6.5 ±0.6 months). Conclusions: Respiratory sinus arrhythmia is reduced after PVI in patients with paroxysmal AF. Our findings suggest that this is related to a decrease in cardiac vagal tone. Whether and how this affects the clinical outcome including exercise capacity need to be determined.

show abstract

“…These results indicate the complexity and multiple functions of the CANS in inducing AF (29). A recent study also indicated that the autonomic imbalance between the sympathetic and parasympathetic tensions could be either pro-arrhythmic or anti-arrhythmic (30). In the present study, we utilized RVTS to successfully induce AF by reducing the ERP and increasing dERP, which was in agreement with published reports (31-34).…”

Section: Discussionmentioning

confidence: 99%

Time-dependent Cervical Vagus Nerve Stimulation and Frequency-dependent Right Atrial Pacing Mediated Inducibility of Atrial Fibrillation

Rao

Hu²,

Zhang³

et al. 2018

Anatol J Cardiol

View full text Add to dashboard Cite

Objective: This study aimed to investigate the effects of right cervical vagus trunk simulation (RVTS) and/or right atrial pacing (RAP) on the induction of atrial fibrillation (AF). Methods: Twenty-four healthy adult dogs were randomly divided into four groups: RAP groups comprising RAP 500 (RAP with 500 beats/min) and RAP 1000 (RAP with 1000 beats/min) and RVTS groups comprising RVTS and RAP 500 +RVTS. All dogs underwent 12-h intermittent RAP and/or RVTS once every 2 h. The AF induction rate, AF duration, atrial effective refractory period (ERP), and dispersion of ERP (dERP) were compared after every 2 h of RAP or/and RVTS. Results: All groups had successful AF induction. The RAP 1000 group had the highest AF induction rate and the longest AF duration. The RAP 1000 group also had a shortened ERP in comparison to the other groups as well as the maximum dERP. Compared to the RAP 500 group, RAP 500 +RVTS had an increased capacity to induce AF as measured by the AF induction rates, AF duration, ERP, and dERP. Conclusion: Increased tension in the vagus nerve and the intrinsic cardiac autonomic nervous system plays an important role in AF induction through different potential mechanisms. Interventions involving the vagus nerve and/or intrinsic cardiac autonomic nervous system can be a future potential therapy for AF.

show abstract

The short‐term impact of the catheter ablation on noninvasive autonomic nervous system parameters in patients with paroxysmal atrial fibrillation

Cited by 12 publications

References 62 publications

Is Increased Resting Heart Rate after Radiofrequency Pulmonary Vein Isolation a Predictor of Favorable Long-Term Outcome of the Procedure?

Is Increased Resting Heart Rate after Radiofrequency Pulmonary Vein Isolation a Predictor of Favorable Long-Term Outcome of the Procedure?

Respiratory sinus arrhythmia is reduced after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

Time-dependent Cervical Vagus Nerve Stimulation and Frequency-dependent Right Atrial Pacing Mediated Inducibility of Atrial Fibrillation

Contact Info

Product

Resources

About