Alterations of heart rate variability after radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins

Ming Hsiung Hsieh, Chuen Wang Chiou, Zu Chi Wen, Chieh Hung Wu, Ching Tai Tai, Chin Feng Tsai, Yu An Ding, Mau Song Chang, Shin Ann Chen

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

Background - Transient sinus bradycardia and hypotension have been reported as complications during radiofrequency (RF) ablation of focal atrial of focal atrial fibrillation (AF) originating from pulmonary veins (PVs). This study used heart rate variability (HRV) to evaluate the effects of focal PVs ablation on autonomic function. Methods and Results - Thirty-seven patients with paroxysmal AF were referred for ablation. The study group included 30 patients who underwent who underwent transseptal ablation of PVs, and the control group included 7 patients who underwent the transseptal procedure without ablation. The mean sinus rate and time-domain (standard deviation of RR intervals and root-mean-square of differences of adjacent RR intervals) and frequency-domain (low frequency, high frequency, and low frequency/high-frequency ratio) analyses of HRV were obtained by use of 24- hour Holter monitoring before and 1 week, 1 month, and 6 months after ablation. All the triggering points of AF were from PVs, and they were successfully ablated. Severe bradycardia and hypotension were noted during ablation of PVs in 6 patients (group IA); 24 patients without the above complication belonged to group lB. Compared with preablation values, a significant increase in mean sinus rate and low-frequency/high-frequency ratio and a significant decrease in standard deviation of RR intervals, root- mean-square of differences of adjacent RR intervals, low frequency, and high frequency were noted in groups IA and IB patients 1 week after ablation. The changes in HR and HRV recovered spontaneously in the 2 subgroups by 1 month later. These parameters of HRV did not change in the control group after the transseptal procedure. Conclusions - Transient autonomic dysfunction with alterations in HR and HRV occurred after ablation of focal AF originating from PVs.

Original languageEnglish
Pages (from-to)2237-2243
Number of pages7
JournalCirculation
Volume100
Issue number22
Publication statusPublished - Nov 30 1999
Externally publishedYes

Fingerprint

Catheter Ablation
Pulmonary Veins
Atrial Fibrillation
Heart Rate
Bradycardia
Hypotension
Control Groups
Ambulatory Electrocardiography

Keywords

  • Ablation
  • Fibrillation
  • Veins

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Hsieh, M. H., Chiou, C. W., Wen, Z. C., Wu, C. H., Tai, C. T., Tsai, C. F., ... Chen, S. A. (1999). Alterations of heart rate variability after radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins. Circulation, 100(22), 2237-2243.

Alterations of heart rate variability after radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins. / Hsieh, Ming Hsiung; Chiou, Chuen Wang; Wen, Zu Chi; Wu, Chieh Hung; Tai, Ching Tai; Tsai, Chin Feng; Ding, Yu An; Chang, Mau Song; Chen, Shin Ann.

In: Circulation, Vol. 100, No. 22, 30.11.1999, p. 2237-2243.

Research output: Contribution to journalArticle

Hsieh, MH, Chiou, CW, Wen, ZC, Wu, CH, Tai, CT, Tsai, CF, Ding, YA, Chang, MS & Chen, SA 1999, 'Alterations of heart rate variability after radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins', Circulation, vol. 100, no. 22, pp. 2237-2243.
Hsieh, Ming Hsiung ; Chiou, Chuen Wang ; Wen, Zu Chi ; Wu, Chieh Hung ; Tai, Ching Tai ; Tsai, Chin Feng ; Ding, Yu An ; Chang, Mau Song ; Chen, Shin Ann. / Alterations of heart rate variability after radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins. In: Circulation. 1999 ; Vol. 100, No. 22. pp. 2237-2243.
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AU - Hsieh, Ming Hsiung

AU - Chiou, Chuen Wang

AU - Wen, Zu Chi

AU - Wu, Chieh Hung

AU - Tai, Ching Tai

AU - Tsai, Chin Feng

AU - Ding, Yu An

AU - Chang, Mau Song

AU - Chen, Shin Ann

PY - 1999/11/30

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N2 - Background - Transient sinus bradycardia and hypotension have been reported as complications during radiofrequency (RF) ablation of focal atrial of focal atrial fibrillation (AF) originating from pulmonary veins (PVs). This study used heart rate variability (HRV) to evaluate the effects of focal PVs ablation on autonomic function. Methods and Results - Thirty-seven patients with paroxysmal AF were referred for ablation. The study group included 30 patients who underwent who underwent transseptal ablation of PVs, and the control group included 7 patients who underwent the transseptal procedure without ablation. The mean sinus rate and time-domain (standard deviation of RR intervals and root-mean-square of differences of adjacent RR intervals) and frequency-domain (low frequency, high frequency, and low frequency/high-frequency ratio) analyses of HRV were obtained by use of 24- hour Holter monitoring before and 1 week, 1 month, and 6 months after ablation. All the triggering points of AF were from PVs, and they were successfully ablated. Severe bradycardia and hypotension were noted during ablation of PVs in 6 patients (group IA); 24 patients without the above complication belonged to group lB. Compared with preablation values, a significant increase in mean sinus rate and low-frequency/high-frequency ratio and a significant decrease in standard deviation of RR intervals, root- mean-square of differences of adjacent RR intervals, low frequency, and high frequency were noted in groups IA and IB patients 1 week after ablation. The changes in HR and HRV recovered spontaneously in the 2 subgroups by 1 month later. These parameters of HRV did not change in the control group after the transseptal procedure. Conclusions - Transient autonomic dysfunction with alterations in HR and HRV occurred after ablation of focal AF originating from PVs.

AB - Background - Transient sinus bradycardia and hypotension have been reported as complications during radiofrequency (RF) ablation of focal atrial of focal atrial fibrillation (AF) originating from pulmonary veins (PVs). This study used heart rate variability (HRV) to evaluate the effects of focal PVs ablation on autonomic function. Methods and Results - Thirty-seven patients with paroxysmal AF were referred for ablation. The study group included 30 patients who underwent who underwent transseptal ablation of PVs, and the control group included 7 patients who underwent the transseptal procedure without ablation. The mean sinus rate and time-domain (standard deviation of RR intervals and root-mean-square of differences of adjacent RR intervals) and frequency-domain (low frequency, high frequency, and low frequency/high-frequency ratio) analyses of HRV were obtained by use of 24- hour Holter monitoring before and 1 week, 1 month, and 6 months after ablation. All the triggering points of AF were from PVs, and they were successfully ablated. Severe bradycardia and hypotension were noted during ablation of PVs in 6 patients (group IA); 24 patients without the above complication belonged to group lB. Compared with preablation values, a significant increase in mean sinus rate and low-frequency/high-frequency ratio and a significant decrease in standard deviation of RR intervals, root- mean-square of differences of adjacent RR intervals, low frequency, and high frequency were noted in groups IA and IB patients 1 week after ablation. The changes in HR and HRV recovered spontaneously in the 2 subgroups by 1 month later. These parameters of HRV did not change in the control group after the transseptal procedure. Conclusions - Transient autonomic dysfunction with alterations in HR and HRV occurred after ablation of focal AF originating from PVs.

KW - Ablation

KW - Fibrillation

KW - Veins

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