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Long-term changes in heart rate variability after radiofrequency catheter ablation for atrial fibrillation: 1-year follow-up study with irrigation tip catheter.

Authors
 KI-WOON KANG  ;  TAE HOON KIM  ;  JUNEBOM PARK  ;  JAE SUN UHM  ;  BOYOUNG JOUNG  ;  CHUN HWANG  ;  MOON-HYUNG LEE  ;  HUI-NAM PAK 
Citation
 JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol.25(7) : 693-700, 2014 
Journal Title
 JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY 
ISSN
 1045-3873 
Issue Date
2014
MeSH
Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/surgery* ; Autonomic Nervous System/physiopathology ; Cardiac Catheterization/instrumentation* ; Cardiac Catheters* ; Catheter Ablation/instrumentation* ; Chi-Square Distribution ; Electrocardiography, Ambulatory ; Equipment Design ; Female ; Heart Rate* ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Recurrence ; Risk Factors ; Therapeutic Irrigation/instrumentation* ; Time Factors ; Treatment Outcome
Keywords
atrial fibrillation ; catheter ablation ; heart rate variability ; irrigation tip catheter
Abstract
BACKGROUND: Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) changes cardiac autonomic nerve activity. However, the long-term effect of RFCA has not yet been evaluated when an open irrigation tip catheter (OITC) was used. Therefore, we hypothesized that AF ablation changes heart rate variability (HRV) that would be maintained over 1 year after OITC ablation and be associated with clinical recurrence of AF. METHODS AND RESULTS: We analyzed pre-RFCA HRV (HRVpre ), HRV at 3 months (HRV3mo ) and 1 year (HRV1yr ) after RFCA using 24-hour Holter monitoring after excluding arrhythmic events in 144 patients (70% male, 57 ± 10 years old, 83% paroxysmal AF) who underwent RFCA with OITC. After RFCA with OITC, the increase in mean heart rate and the reduction in HF or LF/HF were significant at HRV3mo (P < 0.001) and were maintained at HRV1yr (P < 0.001). During 20 ± 8 months of follow-up, 33 of 144 patients (23%) showed clinical recurrence of AF. Patients in the nonrecurrence group showed significant reductions of rMSSD and HF at HRV3mo and HRV1yr , but patients with clinical recurrence did not. In Cox regression analysis, a reduction in LF/HF (ΔLF/HF) ≥0.26 at HRV3mo was significantly associated with clinical recurrence of AF (hazard ratio 2.52, 95% CI 1.19-5.32, P = 0.015). CONCLUSION: In contrast to previous reports about long-term HRV recovery after AF ablation with a conventional catheter, change in cardiac autonomic nervous activity was maintained for 1 year after RFCA when an OITC was used. A reduction in ΔLF/HF ≥0.26 at HRV3mo was independently associated with clinical recurrence of AF after RFCA.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/jce.12398/abstract
DOI
10.1111/jce.12398
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Park, Jun Beom(박준범)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99529
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