Assessment of autonomic nervous system modulation after novel catheter ablation techniques for atrial fibrillation using multiple short-term electrocardiogram recordings
Assessment of autonomic nervous system modulation after novel catheter ablation techniques for atrial fibrillation using multiple short-term electrocardiogram recordings
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DOI：
10.1007/s10840-017-0295-x
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发表时间：
2018-01-01
影响因子：
1.8
通讯作者：
Murohara, Toyoaki
中科院分区：
文献类型：
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作者：
Yanagisawa, Satoshi;Inden, Yasuya;Murohara, Toyoaki
房颤（AF）新型导管消融技术对自主神经系统（ANS）的影响尚不清楚。本研究旨在通过使用3分钟心电图记录评估心率变异性（HRV）参数来评估三种新型导管消融技术治疗阵发性AF后的ANS，纳入了235例接受阵发性AF导管消融术的患者（119例采用灌注尖端，51例采用接触力传感引导，65例采用第二代冷冻球囊消融）。分别于术前及消融后1、3、6、12个月进行HRV分析，消融后3组HRV参数均降低，且持续时间> 1年。与交感神经功能的变化相比，消融后副交感神经功能的降低更为明显。在总人群中，45例患者复发。消融术后12个月，复发组的高频（HF）激光消融显著高于非复发组（1.52 +/- 0.47 vs. 1.26 +/- 0.57 ms（2），p = 0.007）。多变量分析表明，房颤持续时间消融后12个月（风险比1.09，95%置信区间1.04-1.15，p = 0.001）和ln HF（风险比1.91，95%置信区间1.12-3.25，p = 0.017）是消融术后房颤复发的独立预测因素。手术后一年。消融术后1年副交感神经功能增强与消融术后房颤复发相关。
The effect of novel catheter ablation techniques for atrial fibrillation (AF) on the autonomic nervous system (ANS) is unclear. This study aimed to assess the ANS after three novel catheter ablation techniques for paroxysmal AF by evaluating heart rate variability (HRV) parameters using a 3-min electrocardiogram recording.Two hundred and thirty-five patients who underwent catheter ablation for paroxysmal AF (119 in irrigated-tip, 51 in contact-force sensing-guided, and 65 patients in second-generation cryoballoon ablation) were included. HRV analysis was performed at baseline and 1, 3, 6, and 12 months after the ablation.The three ablation groups had similarly decreased HRV parameters after the ablation, and this change was maintained > 1 year. A reduction in parasympathetic nervous function was more apparent after the ablation, compared to changes in the sympathetic nervous function. Of the total population, 45 patients had recurrence. Ln high frequency (HF) 12 months after the ablation was significantly higher in the recurrence group than in the non-recurrence group (1.52 +/- 0.47 vs. 1.26 +/- 0.57 ms(2), p = 0.007). Multivariate analysis demonstrated that AF duration (hazards ratio 1.09, 95% confidence interval 1.04-1.15, p = 0.001) and ln HF 12 months after ablation (hazards ratio 1.91, 95% confidence interval 1.12-3.25, p = 0.017) were independent predictors of AF recurrence after the ablation.ANS modulation after the three catheter ablation methods was similar and maintained > 1 year after the procedure. Higher parasympathetic nervous function at 1 year after ablation was associated with AF recurrence after the ablation.