Abstract 14240: Long-term Changes of Heart Rate Variability After Radiofrequency Catheter Ablation of Atrial Fibrillation: 1 Year Follow-up Study in Irrigation Tip Catheter Era
BACKGROUND: It has been known that radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) changes cardiac autonomic nerve activity, but its long-term effect has not yet been evaluated in the open irrigation tip catheter (OITC) era.
OBJECTIVES: We hypothesized that post-RFCA changes of heart rate variability (HRV) are associated with clinical recurrence of AF and maintained over 1 year after OITC ablation.
METHODS: We analyzed HRVs of pre-RFCA (HRVpre), post-RFCA 3rd month (HRV3mo) and 1year (HRV1yr) with 24-hour Holter after sorting out arrhythmic events in 144 patients (70% male, 57±10 years old, 83% paroxysmal AF) who underwent RFCA with OITC.
RESULTS: After RFCA with OITC, the increase of mean heart rate and reductions of HF or LF/HF were significant in HRV3mo (p<0.001) and maintained in HRV1yr (p<0.01). During 20±8 months follow-up, 33 out of 144 patients (23%) showed clinical recurrence of AF. In contrast to the significant reduction of HRV3mo and 1yr parameters in non-recurrence group, the patients with clinical recurrence did not show the reductions of HF in HRV3mo (p=0.05) and HRV1yr (p=0.189). In the Cox regression analysis, ΔLF/HF≥0.26 in HRV3mo was significantly associated with clinical recurrence of AF (HR 2.52, 95% CI 1.19~5.32, p=0.015).
CONCLUSIONS:: In contrast to the previous reports about long-term HRV recovery after AF ablation with conventional catheter, RFCA-induced change of cardiac autonomic nervous activity maintained for 1-year in the OITC era. ΔLF/HF≥0.26 at HRV3mo was independently associated with clinical recurrence of AF after RFCA.
- © 2013 by American Heart Association, Inc.