Academic Journal
Heart rate dynamics after pulmonary vein isolation: pulsed-field vs. radiofrequency ablation
| العنوان: | Heart rate dynamics after pulmonary vein isolation: pulsed-field vs. radiofrequency ablation |
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| المؤلفون: | Valeriano, C, Buytaert, D, De Schouwer, K, Addeo, L, Geelen, P, De Potter, T |
| المصدر: | Europace ; volume 26, issue Supplement_1 ; ISSN 1099-5129 1532-2092 |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2024 |
| الوصف: | Background The autonomic nervous system (ANS) plays a pivotal role in the onset and maintenance of atrial fibrillation (AF). During thermal ablation, the epicardial ganglionated plexi (GP) can inadvertently be affected, as indicated by a post-ablation increase in heart rate (HR), potentially impacting post-procedural outcomes. Pulsed-field ablation (PFA) offers a safer and potentially more effective alternative, as lesion transmurality is not inversely related to safety as in thermal ablation. However, PFA's tissue selectivity may limit its effectiveness in ablating potential AF triggers like GP. Purpose We aimed to assess the impact of PF and RF energy on GP ablation by examining HR changes following PVI procedures. Methods We examined consecutive paroxysmal AF patients undergoing PVI at a single center, using either a variable-loop circular PFA catheter, as part of the inspIRE trial, or a conventional point-by-point RF catheter (1:2 ratio). ECGs were collected before and after ablation at multiple time points, including 1-hour, 1-day, 1-month, and 3-month intervals, with a 24-hour Holter ECG at 3 months. Patients without obtainable sinus rhythm ECGs at these time points were excluded. We also gathered data on post-ablation antiarrhythmic drug and beta-blocker usage. Data are reported as mean±SD, and analysis employed Student’s t-tests, paired t-tests, chi-squared tests, and multiple linear regression analysis to identify influencing factors. Results A total of 105 patients were included (PF = 35, RF = 70). Baseline demographics were similar (Table A). In the RF group, HR significantly increased at all measured time-points. In contrast, this trend was not observed in the PF group (Figure A and B). Following the procedure, the RF cohort exhibited a significantly higher HR compared to PF (7.3±10.3 vs. 0.8±11 at 1-day, p=0.018), and this difference persisted after 3 months (8.5±10.1 vs. 0.9±9, p<0.001, Figure C). These findings remained consistent when HR was assessed using Holter ECG data (HR at 3 ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1093/europace/euae102.121 |
| الاتاحة: | http://dx.doi.org/10.1093/europace/euae102.121 https://academic.oup.com/europace/article-pdf/26/Supplement_1/euae102.121/57870379/euae102.121.pdf |
| Rights: | https://creativecommons.org/licenses/by-nc/4.0/ |
| رقم الانضمام: | edsbas.409789B1 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/europace/euae102.121 |
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