Arrhythmias & electrophysiology
Cardiac deceleration/acceleration capacity demonstrates autonomic modulation in patients with paroxysmal atrial fibrillation undergoing pulsed-field ablation
Authors' conclusion
Our evaluation via DC/AC revealed significant alterations in autonomic activity after PFA. Furthermore, DC/AC and their trajectories demonstrated moderate predictive value for AF recurrence, underscoring the need to reconsider the impact of PFA on cardiac autonomic innervation.
Study context
- Population
- Patients with paroxysmal atrial fibrillation (PAF) undergoing pulsed-field ablation (PFA)consecutive patients with PAF who experienced PFA
- Participants
- 45 patients
- Exposure
- Deceleration capacity (DC)/acceleration capacity (AC) and heart rate variability (HRV) at baseline, immediately after ablation, and at 3-month follow-up
- Outcome
- Pulmonary vein isolation success
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Intraprocedural vagal responses
91.1%
Observational data: associations, not effects.
Further findings
DC and |AC| · immediately after PFA and at 3 months
- DC and |AC| decreased immediately after PFA and partially recovered at 3 months
- overall P < .05 for both
Correlation of HRV parameters with DC/AC
- Most HRV parameters had weak correlations with DC/AC (Pearson r)
- 0.08-0.67
Drug-free atrial tachycardia-free rate · 12 months
- Drug-free atrial tachycardia-free rate
- 75.56%
Prediction of atrial fibrillation (AF) recurrence (area under the curve)
- Preablation DC/AC
- 0.63/0.64
- Changes in DC/AC
- 0.68/0.67
AF recurrence by autonomic indices (Kaplan-Meier) · 12 months
- Lower preablation |AC| and smaller ΔDC/ΔAC had significantly higher AF recurrence rates
- log-rank P < .05
Original publication
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