{"title":"阵发性心房颤动导管消融后运动耐量与自主神经系统调节的关系。","authors":"Natsumi Toyoda, Tomotaka Yoshiyama, Shiho Wakasa, Shun Hirayama, Kohei Fukuda, Tomoya Yanagishita, Atsushi Shibata, Daiju Fukuda","doi":"10.1007/s00380-025-02543-5","DOIUrl":null,"url":null,"abstract":"<p><p>Autonomic nervous system (ANS) modulation increases the heart rate (HR) after catheter ablation (CA) for paroxysmal atrial fibrillation (PAF). However, its influence on exercise tolerance (ET) is poorly understood. This single-center retrospective cohort study enrolled patients who underwent CA for PAF. To analyze the effects of ANS modulation on ET, cardiopulmonary stress testing was performed before and 3 and 12 months after CA. The final analysis included 25 patients in the cryoballoon ablation (CBA) group and 24 in the radiofrequency CA (RFCA) group. HR increased at 3 and 12 months after CA compared with preoperative values (64.8 ± 8.6 vs. 77.7 ± 10.9, p < 0.001; 64.8 ± 8.6 vs. 74.8 ± 11.4, p < 0.001). ANS modulation was more frequent in the CBA group than in the RFCA group at 3 and 12 months after CA (64% vs. 21%, p < 0.01; 48% vs. 4%, p < 0.01). However, no significant difference in ET was observed before and after CA (anaerobic threshold 15.2 ± 2.8 vs. 15.7 ± 2.8, p = 0.46; 15.4 ± 3.0 vs. 16.3 ± 3.9, p = 0.38; peak VO2 23.5 ± 5.7 vs. 24.4 ± 5.2, p = 0.44; 23.0 ± 6.0 vs. 25.3 ± 7.7; p = 0.43) at both 3 and 12 months after CA. ANS modulation was more frequently observed in the CBA group than in the RFCA group. ET was not worsened by ANS modulation after CA.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":"934-942"},"PeriodicalIF":1.5000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Relationship between exercise tolerance and autonomic nervous system modulation after catheter ablation for paroxysmal atrial fibrillation.\",\"authors\":\"Natsumi Toyoda, Tomotaka Yoshiyama, Shiho Wakasa, Shun Hirayama, Kohei Fukuda, Tomoya Yanagishita, Atsushi Shibata, Daiju Fukuda\",\"doi\":\"10.1007/s00380-025-02543-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Autonomic nervous system (ANS) modulation increases the heart rate (HR) after catheter ablation (CA) for paroxysmal atrial fibrillation (PAF). However, its influence on exercise tolerance (ET) is poorly understood. This single-center retrospective cohort study enrolled patients who underwent CA for PAF. To analyze the effects of ANS modulation on ET, cardiopulmonary stress testing was performed before and 3 and 12 months after CA. The final analysis included 25 patients in the cryoballoon ablation (CBA) group and 24 in the radiofrequency CA (RFCA) group. HR increased at 3 and 12 months after CA compared with preoperative values (64.8 ± 8.6 vs. 77.7 ± 10.9, p < 0.001; 64.8 ± 8.6 vs. 74.8 ± 11.4, p < 0.001). ANS modulation was more frequent in the CBA group than in the RFCA group at 3 and 12 months after CA (64% vs. 21%, p < 0.01; 48% vs. 4%, p < 0.01). However, no significant difference in ET was observed before and after CA (anaerobic threshold 15.2 ± 2.8 vs. 15.7 ± 2.8, p = 0.46; 15.4 ± 3.0 vs. 16.3 ± 3.9, p = 0.38; peak VO2 23.5 ± 5.7 vs. 24.4 ± 5.2, p = 0.44; 23.0 ± 6.0 vs. 25.3 ± 7.7; p = 0.43) at both 3 and 12 months after CA. ANS modulation was more frequently observed in the CBA group than in the RFCA group. ET was not worsened by ANS modulation after CA.</p>\",\"PeriodicalId\":12940,\"journal\":{\"name\":\"Heart and Vessels\",\"volume\":\" \",\"pages\":\"934-942\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart and Vessels\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00380-025-02543-5\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart and Vessels","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00380-025-02543-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/6 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
自主神经系统（ANS）调节增加阵发性心房颤动（PAF）导管消融（CA）后的心率（HR）。然而，它对运动耐量（ET）的影响却知之甚少。这项单中心回顾性队列研究纳入了因PAF接受CA治疗的患者。为了分析ANS调节对ET的影响，我们在CA前、CA后3个月和12个月分别进行了心肺压力测试。最终的分析包括25例低温球囊消融（CBA）组和24例射频CA （RFCA）组。与术前相比，CA后3个月和12个月HR升高（64.8±8.6 vs 77.7±10.9,p < 0.001）；64.8±8.6 vs. 74.8±11.4,p < 0.001)。在CA后3个月和12个月，CBA组的ANS调制频率高于RFCA组(64%比21%，p < 0.01；48% vs. 4%, p < 0.01)。然而，CA前后ET无显著差异(无氧阈值15.2±2.8 vs 15.7±2.8,p = 0.46；15.4±3.0 vs. 16.3±3.9,p = 0.38；峰值VO2 23.5±5.7 vs. 24.4±5.2,p = 0.44；23.0±6.0 vs. 25.3±7.7；p = 0.43)。与RFCA组相比，CBA组更频繁地观察到ANS调制。CA后ANS调制未使ET恶化。
Relationship between exercise tolerance and autonomic nervous system modulation after catheter ablation for paroxysmal atrial fibrillation.
Autonomic nervous system (ANS) modulation increases the heart rate (HR) after catheter ablation (CA) for paroxysmal atrial fibrillation (PAF). However, its influence on exercise tolerance (ET) is poorly understood. This single-center retrospective cohort study enrolled patients who underwent CA for PAF. To analyze the effects of ANS modulation on ET, cardiopulmonary stress testing was performed before and 3 and 12 months after CA. The final analysis included 25 patients in the cryoballoon ablation (CBA) group and 24 in the radiofrequency CA (RFCA) group. HR increased at 3 and 12 months after CA compared with preoperative values (64.8 ± 8.6 vs. 77.7 ± 10.9, p < 0.001; 64.8 ± 8.6 vs. 74.8 ± 11.4, p < 0.001). ANS modulation was more frequent in the CBA group than in the RFCA group at 3 and 12 months after CA (64% vs. 21%, p < 0.01; 48% vs. 4%, p < 0.01). However, no significant difference in ET was observed before and after CA (anaerobic threshold 15.2 ± 2.8 vs. 15.7 ± 2.8, p = 0.46; 15.4 ± 3.0 vs. 16.3 ± 3.9, p = 0.38; peak VO2 23.5 ± 5.7 vs. 24.4 ± 5.2, p = 0.44; 23.0 ± 6.0 vs. 25.3 ± 7.7; p = 0.43) at both 3 and 12 months after CA. ANS modulation was more frequently observed in the CBA group than in the RFCA group. ET was not worsened by ANS modulation after CA.
期刊介绍：
Heart and Vessels is an English-language journal that provides a forum of original ideas, excellent methods, and fascinating techniques on cardiovascular disease fields. All papers submitted for publication are evaluated only with regard to scientific quality and relevance to the heart and vessels. Contributions from those engaged in practical medicine, as well as from those involved in basic research, are welcomed.
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