AI Article Synopsis
- The study investigates the link between autonomic nervous activity and the recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI), revealing significant changes in heart rate measures.
- Post-PVI, the non-recurrence group showed significant decreases in heart rate metrics and heart rate variability (HRV) indicators, unlike the recurrence group.
- The findings suggest that managing autonomic balance is crucial for preventing AF recurrence post-PVI, emphasizing the need for reducing overall vagosympathetic activity.
Article Abstract
Objective: Pulmonary vein isolation (PVI) has been widely used for the treatments of paroxysmal atrial fibrillation (PAF); however, AF recurrence remains a significant challenge. We evaluated relation between autonomic nervous activity and AF recurrence using heart rate variability (HRV) and deceleration and acceleration capacity (DC/AC) analyses.
Methods: High-resolution Holter electrocardiogram was performed in 56 PAF patients pre- and 3 and 6 months post-PVI by cryoballoon. HRV and DC/AC analysis data were compared between the non-recurrence and recurrence groups.
Results: AF recurrence occurred in 10 cases. Total heart beats and maximum heart rate significantly decreased and minimum heart rate increased only in the non-recurrence group post-PVI. In HRV analysis, root mean square successive difference (RMSSD), low-frequency components (LF), high frequency components (HF) and LF/HF significantly decreased only in the non-recurrence group at both 3 and 6 months post-PVI; in contrast, significant decreases in RMSSD, LF and HF were observed in the recurrence group only at 6 months. In DC/AC analysis, DC significantly decreased in both groups post-PVI; in contrast, AC increased only in the non-recurrence group, resulting in significantly greater [AC]/DC ratio in the recurrence group at 3 months post-PVI.
Conclusions: To prevent AF recurrence after PVI, it is important not only to reduce vagosympathetic overall activity but also to minimize imbalance between vagosympathetic reflex responses.
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