scholarly journals A “square root” pattern of changes in the heart rate variability during the first year after circumferential pulmonary vein isolation for paroxysmal atrial fibrillation and their relation with long-term arrhythmia recurrence

2020 ◽  
Author(s):  
Milan Marinković ◽  
Nebojša Mujović ◽  
Vera Vučićević ◽  
Jan Steffel ◽  
Tatjana S. Potpara
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Paroxysmal Atrial Fibrillation ◽  
First Year ◽  
Square Root ◽  
Circumferential Pulmonary Vein Isolation

scholarly journals Cryoballoon Versus High-Power, Short-Duration Radiofrequency Ablation for Pulmonary Vein Isolation in Patients With Paroxysmal Atrial Fibrillation

2021 ◽  
Vol 14 (9) ◽  
Author(s):  
Hui-Nam Pak ◽  
Je-Wook Park ◽  
Song-Yi Yang ◽  
Tae-Hoon Kim ◽  
Jae-Sun Uhm ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
High Power ◽  
Paroxysmal Atrial Fibrillation ◽  
Antiarrhythmic Drugs ◽  
Procedure Time

Background: The efficacy of cryoballoon pulmonary vein isolation (Cryo-PVI) is equivalent to that of radiofrequency pulmonary vein isolation in patients with paroxysmal atrial fibrillation (AF). We aimed to compare the efficacy and safety profile of Cryo-PVI and high-power, short-duration (HPSD) radiofrequency catheter ablation (RFCA) in patients with AF. Methods: We prospectively randomized 314 patients with paroxysmal AF (men, 71.3%; 59.9±10.9 years old) to either the Cryo-PVI group (n=156) or HPSD-RFCA group (n=158). Cavotricuspid isthmus ablation and linear ablation from the superior vena cava to the right atrial septum in addition to pulmonary vein isolation were carried out in the majority of patients in the HPSD-RFCA group. The primary end point was AF recurrence after a single procedure; secondary end points were the recurrence pattern, cardioversion rate, follow-up heart rate variability, and response to antiarrhythmic drugs. Results: After a mean follow-up of 9.8±5.1 months, the clinical recurrence rate did not significantly differ between the two groups (log-rank P =0.840). The rate of recurrence as atrial tachycardia ( P >0.999), cardioversion ( P =0.999), and 3-month heart rate variability (high frequency; P =0.506) did not significantly differ. During the final follow-up, sinus rhythm was maintained without antiarrhythmic drugs in 70.5% of the Cryo-PVI group and 73.4% of the HPSD-RFCA group ( P =0.567). No significant difference was found in the major complication rate between the two groups (3.8% versus 0.6%; P =0.066), but total procedure time was significantly shorter in the Cryo-PVI group (78.5±20.2 versus 124.5±37.1 minutes; P <0.001). Conclusions: In patients with paroxysmal AF, the Cryo-PVI is an effective rhythm-control strategy with a shorter procedure time compared with the HPSD-RFCA. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03920917.

scholarly journals Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Kejing Wang ◽  
Dong Chang ◽  
Zhenliang Chu ◽  
Yanzong Yang ◽  
Lianjun Gao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Pulmonary Vein ◽  
Paroxysmal Atrial Fibrillation ◽  
Multivariate Logistic Regression Analysis ◽  
Common Mechanism ◽  
Success Rates ◽  
Before And After

Backgrounds. Segmental and circumferential pulmonary vein isolations (SPVI and CPVI) have been demonstrated to be effective therapies for paroxysmal atrial fibrillation (PAF). PVI is well established as the endpoint of different ablation techniques, whereas it may not completely account for the long-term success.Methods. 181 drug-refractory symptomatic PAF patients were referred for segmental or circumferential PVI (SPVI = 67; CPVI = 114). Heart rate variability (HRV) was assessed before and after the final ablation.Results. After following up for62.23±12.75months, patients underwent1.41±0.68procedures in average, and the success rates in SPVI and CPVI groups were comparable. 119 patients were free from AF recurrence (SPVI-S,n=43; CPVI-S,n=76). 56 patients had recurrent episodes (SPVI-R,n=21; CPVI-R,n=35). Either ablation technique decreased HRV significantly. Postablation SDNN and rMSSD were significantly lower in SPVI-S and CPVI-S subgroups than in SPVI-R and CPVI-R subgroups (SPVI-S versus SPVI-R: SDNN91.8±32.6versus111.5±36.2 ms, rMSSD47.4±32.3versus55.2±35.2 ms; CPVI-S versus CPVI-R: SDNN83.0±35.6versus101.0±40.7 ms, rMSSD41.1±22.9versus59.2±44.8 ms; allP<0.05). Attenuation of SDNN and rMSSD remained for 12 months in SPVI-S and CPVI-S subgroups, whereas it recovered earlier in SPVI-R and CPVI-R subgroups. Multivariate logistic regression analysis identified SDNN as the only predictor of long-term success.Conclusions. Beyond PVI, denervation may be a common mechanism underlying different ablation strategies for PAF.

scholarly journals 778 Heart rate variability after circumferential pulmonary veins catheter ablation in patients with paroxysmal atrial fibrillation: long-term follow-up results

EP Europace ◽  
2005 ◽  
Vol 7 (Supplement_1) ◽  
pp. 177-177
Author(s):  
K. Szydlo ◽  
A. Wnuk-Wojnar ◽  
M. Trusz-Gluza ◽  
C. Czerwinski ◽  
I. Wozniak-Skowerska ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Pulmonary Veins ◽  
Long Term Follow Up

Three-Dimensional Impedance Mapping as an Aid to Circumferential Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation

2009 ◽  
Vol 62 (3) ◽  
pp. 315-319
Author(s):  
Alonso Pedrote ◽  
Eduardo Arana-Rueda ◽  
Lorena García-Riesco ◽  
Adriano Jiménez-Velasco ◽  
Juan Sánchez-Brotons ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Paroxysmal Atrial Fibrillation ◽  
Three Dimensional ◽  
Circumferential Pulmonary Vein Isolation

P2466The impact of circumferential pulmonary vein isolation on global and regional left atrial function in patients with paroxysmal atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Blendea ◽  
S Istratoaie ◽  
S Pop ◽  
M Mansour
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Atrial ◽  
Lateral Wall ◽  
Interatrial Septum ◽  
Tissue Doppler ◽  
Doppler Flow ◽  
Circumferential Pulmonary Vein Isolation

Abstract Introduction The effect of circumferential pulmonary vein isolation (PVI) for atrial fibrillation (AF) on left atrial (LA) function has not been well defined. Purpose The aim of this study was to evaluate the immediate impact of ablation on parameters of global and regional LA function using intracardiac echocardiography (ICE) Methods We studied 26 consecutive patients (age 56±10 years, 19 men) with paroxysmal AF using ICE before and immediately after circumferential PVI. All pulmonary veins were isolated in all patients. ICE measurements included LA fractional area shortening, peak A wave on transmitral Doppler flow, peak emptying velocity on the left atrial appendage (LAA) Doppler flow, as well as tissue Doppler myocardial velocities at the level of the posterior LA wall, interatrial septum, and lateral wall, which were used as parameters of regional LA function. Results The mean radiofrequency ablation time was 37±22min. Post ablation there was a significant reduction of the LA fractional area shortening from 27±8% to 22±6% (p<0.01). The tissue Doppler velocity of atrial contraction at the posterior wall decreased significantly post ablation: from 8.9±1.8 cm/s to 6.9±1.4 cm/s (p<0.01). There were no significant differences between the pre and post ablation values for tissue Doppler velocities at the level of the interatrial septum or LA lateral wall. The post ablation peak transmitral A wave and peak LAA Doppler velocities did not differ significantly from the pre ablation values. Conclusion In patients with paroxysmal atrial fibrillation, circumferential PVI results in an immediate decrease in LA function without a significant change in LAA function.

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