Arrhythmias & electrophysiology
Impact of Pulsed-Field Ablation on Intrinsic Cardiac Autonomic Nervous System After Pulmonary Vein Isolation
Authors' conclusion
We report a significantly lower S100 release following PFA PVI vs CBA PVI even if silent cerebral emboli were excluded. Notably, vagal response during PFA was not associated with S100 release.
Study context
- Population
- Patients undergoing pulmonary vein isolation
- Participants
- 97 patients
- Exposure
- Pulsed-field ablation (PFA) vs cryoballoon ablation (CBA) for pulmonary vein isolation (PVI)
- PFAn = 54
- CBAn = 43reference
- Outcome
- Serum S100 increase (ΔS100), a denervation biomarker
Main finding
As reported in the abstract
ΔS100
PFA
0.035
IQR 0.02-0.063 μg/L · μg/L
CBA
0.12
IQR 0.09-0.17 μg/L · μg/L
P < 0.0001
Observational data: associations, not effects.
Further findings
- Transient bradycardia during PFA PVI
- 56% · 30 of 54
ΔS100 excluding patients with cerebral emboli
- ΔS100 lower in PFA
Transient bradycardia during PFA PVI
- ΔS100 similar with or without transient bradycardia
Safety
Silent cerebral emboli on MRI
P = 0.773
Original publication
Impact of Pulsed-Field Ablation on Intrinsic Cardiac Autonomic Nervous System After Pulmonary Vein Isolation. JACC Clin Electrophysiol. Published 19 July 2023. doi:10.
Summarised from the published abstract; every number is checked against it