Academic Journal
Quantitative assessment of transient autonomic modulation after single‐shot pulmonary vein isolation with pulsed‐field ablation
| العنوان: | Quantitative assessment of transient autonomic modulation after single‐shot pulmonary vein isolation with pulsed‐field ablation |
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| المؤلفون: | Del Monte, Alvise, Cespón Fernández, María, Vetta, Giampaolo, Della Rocca, Domenico Giovanni, Pannone, Luigi, Mouram, Sahar, Sorgente, Antonio, Bala, Gezim, Ströker, Erwin, Sieira, Juan, Almorad, Alexandre, Sarkozy, Andrea, Chierchia, Gian‐Battista, de Asmundis, Carlo |
| المصدر: | Journal of Cardiovascular Electrophysiology ; volume 34, issue 11, page 2393-2397 ; ISSN 1045-3873 1540-8167 |
| بيانات النشر: | Wiley |
| سنة النشر: | 2023 |
| المجموعة: | Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: | Introduction Pulmonary vein isolation (PVI) with thermal energy is characterized by concomitant ablation of the surrounding ganglionated plexi (GP). Pulsed‐field ablation (PFA) selectively targets the myocardium and seems associated with only negligible effects on the autonomic nervous system (ANS). However, little is known about the dynamic effects of PFA on the GP immediately after PVI. This study sought to investigate the degree and acute vagal modulation induced by the Farapulse TM PFA system during PVI compared with single‐shot thermal ablation. Methods A total of 76 patients underwent first‐time PVI with either Farapulse TM PFA (PFA group, n = 40) or cryoballoon ablation (thermal ablation group, n = 36) for paroxysmal atrial fibrillation (AF). The effect on the ANS in the two groups was assessed before and after PVI with extracardiac vagal stimulation (ECVS). To capture any transient effects of PFA on the ANS, in a subgroup of PFA patients ECVS was repeated at three predefined timepoints: (1) before PVI (T0); (2) immediately after PVI (T1); and (3) 10 min after the last energy application (T2). Results Despite similar baseline values, the vagal response induced by ECVS after PVI almost disappeared in the thermal ablation group but persisted in the PFA group (thermal group: 840 [706–1090] ms, p < .001 compared to baseline; PFA group: 11 466 [8720–12 293] ms, p = .70 compared to baseline). Intraprocedural vagal reactions (defined as RR increase >50%, transitory asystole, or atrioventricular block) occurred more frequently with PFA than thermal ablation (70% vs. 28%, p = .001). Moreover, heart rate 24 h post‐PVI increased more with thermal ablation than with PFA (16.5 ± 9.0 vs. 2.6 ± 6.1 beats/min, p < .001). In the subgroup of PFA patients undergoing repeated ANS modulation assessment ( n = 11), ECVS demonstrated that PFA determined a significant acute suppression of the vagal response immediately after PVI ( p < .001 compared to baseline), which recovered almost completely within 10 ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1111/jce.16089 |
| الاتاحة: | https://doi.org/10.1111/jce.16089 https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.16089 |
| Rights: | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| رقم الانضمام: | edsbas.EA671220 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1111/jce.16089 |
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