Abstract
Purpose
The effect of novel catheter ablation techniques for atrial fibrillation (AF) on the autonomic nervous system (ANS) is unclear. This study aimed to assess the ANS after three novel catheter ablation techniques for paroxysmal AF by evaluating heart rate variability (HRV) parameters using a 3-min electrocardiogram recording.
Methods
Two hundred and thirty-five patients who underwent catheter ablation for paroxysmal AF (119 in irrigated-tip, 51 in contact-force sensing-guided, and 65 patients in second-generation cryoballoon ablation) were included. HRV analysis was performed at baseline and 1, 3, 6, and 12 months after the ablation.
Results
The three ablation groups had similarly decreased HRV parameters after the ablation, and this change was maintained > 1 year. A reduction in parasympathetic nervous function was more apparent after the ablation, compared to changes in the sympathetic nervous function. Of the total population, 45 patients had recurrence. Ln high frequency (HF) 12 months after the ablation was significantly higher in the recurrence group than in the non-recurrence group (1.52 ± 0.47 vs. 1.26 ± 0.57 ms2, p = 0.007). Multivariate analysis demonstrated that AF duration (hazards ratio 1.09, 95% confidence interval 1.04–1.15, p = 0.001) and ln HF 12 months after ablation (hazards ratio 1.91, 95% confidence interval 1.12–3.25, p = 0.017) were independent predictors of AF recurrence after the ablation.
Conclusions
ANS modulation after the three catheter ablation methods was similar and maintained > 1 year after the procedure. Higher parasympathetic nervous function at 1 year after ablation was associated with AF recurrence after the ablation.
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Acknowledgments
This study was funded by the Medtronic Japan.
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Satoshi Yanagisawa and Rei Shibata are affiliated with a department sponsored by the Medtronic Japan. Yasuya Inden, Aya Fujii, Yosuke Kamikubo, Yasunori Kanzaki, Monami Ando, Junya Funabiki, Yosuke Murase, Masaki Takenaka, Noriaki Otake, Yoshihiro Ikai, Yusuke Sakamoto, and Toyoaki Murohara declare that they have no conflict of interest.
Human and animal rights and informed consent
The study population was retrospectively recruited from a catheter ablation database at the Nagoya University Hospital, Japan. This ablation database was approved by our institutional ethics committee. This study was performed in compliance with the Declaration of Helsinki.
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Yanagisawa, S., Inden, Y., Fujii, A. et al. Assessment of autonomic nervous system modulation after novel catheter ablation techniques for atrial fibrillation using multiple short-term electrocardiogram recordings. J Interv Card Electrophysiol 51, 35–44 (2018). https://doi.org/10.1007/s10840-017-0295-x
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DOI: https://doi.org/10.1007/s10840-017-0295-x