(Circulation. 1999;100:2237.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Alterations of Heart Rate Variability After Radiofrequency Catheter Ablation of Focal Atrial Fibrillation Originating From Pulmonary Veins
Presented in part at the 48th Scientific Sessions of the American College of Cardiology, New Orleans, La, March 9, 1999, and published in abstract form (J Am Coll Cardiol. 1999;33:144A). Also presented in part at the 20th Scientific Sessions of the North American Society of Pacing and Electrophysiology, Toronto, Canada, May 14, 1999, and published in abstract form (Pacing Clin Electrophysiol. 1999;22:857).
From the Division of Cardiology, Department of Medicine, National Yang-Ming University, School of Medicine, and Veterans General Hospital-Taipei (Z.-C.W., C.-H.W., C.-T.T., C.-F.T., Y.-A.D., M.-S.C., S.-A.C.), and Kaohsiung (C.-W.C.), Taiwan, ROC, and the Division of Cardiovascular Medicine, Taipei Medical College and Taipei Wan-Fang Hospital. Dr Hsieh is currently with the Division of Cardiovascular Medicine, Taipei Medical College and is affiliated with Taipei Wan-Fang Hospital.
Correspondence to Shih-Ann Chen, MD, Division of Cardiology, Veterans General Hospital-Taipei, 201 Sec 2, Shih-Pai Road, Taipei, Taiwan, ROC. E-mail sachen{at}vghtpe.gov.tw
Background—Transient sinus bradycardia and hypotension have been reported as complications during radiofrequency (RF) ablation of focal atrial fibrillation (AF) originating from pulmonary veins (PVs). This study used heart rate variability (HRV) to evaluate the effects of focal PVs ablation on autonomic function.
Methods and Results—Thirty-seven patients with paroxysmal AF were referred for ablation. The study group included 30 patients who underwent transseptal ablation of PVs, and the control group included 7 patients who underwent the transseptal procedure without ablation. The mean sinus rate and time-domain (standard deviation of RR intervals and root-mean-square of differences of adjacent RR intervals) and frequency-domain (low frequency, high frequency, and low-frequency/high-frequency ratio) analyses of HRV were obtained by use of 24-hour Holter monitoring before and 1 week, 1 month, and 6 months after ablation. All the triggering points of AF were from PVs, and they were successfully ablated. Severe bradycardia and hypotension were noted during ablation of PVs in 6 patients (group IA); 24 patients without the above complication belonged to group IB. Compared with preablation values, a significant increase in mean sinus rate and low-frequency/high-frequency ratio and a significant decrease in standard deviation of RR intervals, root-mean-square of differences of adjacent RR intervals, low frequency, and high frequency were noted in groups IA and IB patients 1 week after ablation. The changes in HR and HRV recovered spontaneously in the 2 subgroups by 1 month later. These parameters of HRV did not change in the control group after the transseptal procedure.
Conclusions—Transient autonomic dysfunction with alterations in HR and HRV occurred after ablation of focal AF originating from PVs.
Key Words: fibrillation • veins • ablation
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