Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation
| Autor: | Peixin Cong, Jingjing Jia, Kejing Wang, Xiaomeng Yin, Shulong Zhang, Lianjun Gao, Yunlong Xia, Zhenliang Chu, Yingxue Dong, Dong Chang, Yanzong Yang |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Article Subject medicine.medical_treatment lcsh:Medicine Catheter ablation lcsh:Technology General Biochemistry Genetics and Molecular Biology Pulmonary vein Heart Rate Recurrence Internal medicine Atrial Fibrillation Heart rate medicine Humans Heart rate variability lcsh:Science General Environmental Science medicine.diagnostic_test lcsh:T business.industry lcsh:R Atrial fibrillation General Medicine Middle Aged Ablation medicine.disease Denervation Logistic Models Treatment Outcome Pulmonary Veins Anesthesia Multivariate Analysis Ambulatory Catheter Ablation Electrocardiography Ambulatory Clinical Study Cardiology lcsh:Q Female business Electrocardiography |
| Zdroj: | The Scientific World Journal The Scientific World Journal, Vol 2013 (2013) |
| ISSN: | 1537-744X |
| DOI: | 10.1155/2013/569564 |
| Popis: | Backgrounds. Segmental and circumferential pulmonary vein isolations (SPVI and CPVI) have been demonstrated to be effective therapies for paroxysmal atrial fibrillation (PAF). PVI is well established as the endpoint of different ablation techniques, whereas it may not completely account for the long-term success.Methods. 181 drug-refractory symptomatic PAF patients were referred for segmental or circumferential PVI (SPVI = 67; CPVI = 114). Heart rate variability (HRV) was assessed before and after the final ablation.Results. After following up for62.23±12.75months, patients underwent1.41±0.68procedures in average, and the success rates in SPVI and CPVI groups were comparable. 119 patients were free from AF recurrence (SPVI-S,n=43; CPVI-S,n=76). 56 patients had recurrent episodes (SPVI-R,n=21; CPVI-R,n=35). Either ablation technique decreased HRV significantly. Postablation SDNN and rMSSD were significantly lower in SPVI-S and CPVI-S subgroups than in SPVI-R and CPVI-R subgroups (SPVI-S versus SPVI-R: SDNN91.8±32.6versus111.5±36.2 ms, rMSSD47.4±32.3versus55.2±35.2 ms; CPVI-S versus CPVI-R: SDNN83.0±35.6versus101.0±40.7 ms, rMSSD41.1±22.9versus59.2±44.8 ms; allP<0.05). Attenuation of SDNN and rMSSD remained for 12 months in SPVI-S and CPVI-S subgroups, whereas it recovered earlier in SPVI-R and CPVI-R subgroups. Multivariate logistic regression analysis identified SDNN as the only predictor of long-term success.Conclusions. Beyond PVI, denervation may be a common mechanism underlying different ablation strategies for PAF. |
| Databáze: | OpenAIRE |
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