{"title":"Short-term deceleration capacity: a novel non-invasive indicator of parasympathetic activity in patients undergoing pulmonary vein isolation.","authors":"Łukasz Zarębski, Piotr Futyma","doi":"10.1007/s10840-024-01899-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Subtypes of atrial fibrillation (AF) can differ, and exact mechanisms in which patients benefit from the pulmonary vein isolation (PVI) remain not fully understood. During PVI, vagal innervation of the heart may also be affected. Thus, non-invasive methods of intraprocedural assessment of such PVI impact are sought.</p><p><strong>Methods: </strong>From 1-minute ECG recordings performed before and after PVI, we investigated short-term deceleration capacity (ST-DC) and short-term heart rate variability (ST-HRV) to determine their potential as indicators of parasympathetic activity before and after ablation.</p><p><strong>Results: </strong>In 24 consecutive patients with paroxysmal AF included in the study, there were a significant differences in ST-DC and ST-HRV parameters measured before and after PVI. After 3 months, patients with baseline ST-DC ≥ 7.5 ms were less likely to experience AF recurrence when compared to patients with baseline ST-DC < 7.5 ms (0% vs 31%, p = 0.0496). There were no differences in AF recurrence after 12 months of follow-up (36% vs 38%, p = 0.52).</p><p><strong>Conclusion: </strong>PVI leads to significant changes in ST-DC and ST-HRV, and these parameters can serve as indicators of vagal denervation after AF ablation. Patients with more prominent baseline ST-DC are less likely to experience AF recurrence during the post-PVI 3-month blanking period.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Interventional Cardiac Electrophysiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10840-024-01899-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Subtypes of atrial fibrillation (AF) can differ, and exact mechanisms in which patients benefit from the pulmonary vein isolation (PVI) remain not fully understood. During PVI, vagal innervation of the heart may also be affected. Thus, non-invasive methods of intraprocedural assessment of such PVI impact are sought.
Methods: From 1-minute ECG recordings performed before and after PVI, we investigated short-term deceleration capacity (ST-DC) and short-term heart rate variability (ST-HRV) to determine their potential as indicators of parasympathetic activity before and after ablation.
Results: In 24 consecutive patients with paroxysmal AF included in the study, there were a significant differences in ST-DC and ST-HRV parameters measured before and after PVI. After 3 months, patients with baseline ST-DC ≥ 7.5 ms were less likely to experience AF recurrence when compared to patients with baseline ST-DC < 7.5 ms (0% vs 31%, p = 0.0496). There were no differences in AF recurrence after 12 months of follow-up (36% vs 38%, p = 0.52).
Conclusion: PVI leads to significant changes in ST-DC and ST-HRV, and these parameters can serve as indicators of vagal denervation after AF ablation. Patients with more prominent baseline ST-DC are less likely to experience AF recurrence during the post-PVI 3-month blanking period.
期刊介绍:
The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.