Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation
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...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2013/569564 |
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| author | Kejing Wang Dong Chang Zhenliang Chu Yanzong Yang Lianjun Gao Shulong Zhang Yunlong Xia Yingxue Dong Xiaomeng Yin Peixin Cong Jingjing Jia |
| author_facet | Kejing Wang Dong Chang Zhenliang Chu Yanzong Yang Lianjun Gao Shulong Zhang Yunlong Xia Yingxue Dong Xiaomeng Yin Peixin Cong Jingjing Jia |
| author_sort | Kejing Wang |
| collection | DOAJ |
| description | 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 for 62.23±12.75 months, patients underwent 1.41±0.68 procedures 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: SDNN 91.8±32.6 versus 111.5±36.2 ms, rMSSD 47.4±32.3 versus 55.2±35.2 ms; CPVI-S versus CPVI-R: SDNN 83.0±35.6 versus 101.0±40.7 ms, rMSSD 41.1±22.9 versus 59.2±44.8 ms; all P<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. |
| format | Article |
| id | doaj-art-619ef0b8c3044b84b8fb3266f503bf8e |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-619ef0b8c3044b84b8fb3266f503bf8e2025-02-03T01:20:15ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/569564569564Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after AblationKejing Wang0Dong Chang1Zhenliang Chu2Yanzong Yang3Lianjun Gao4Shulong Zhang5Yunlong Xia6Yingxue Dong7Xiaomeng Yin8Peixin Cong9Jingjing Jia10Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaDepartment of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaDepartment of Cardiology, Jiaxing Second Hospital, Jiaxing 314000, ChinaDepartment of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaDepartment of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaDepartment of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaDepartment of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaDepartment of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaDepartment of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaDepartment of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaDepartment of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, ChinaBackgrounds. 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 for 62.23±12.75 months, patients underwent 1.41±0.68 procedures 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: SDNN 91.8±32.6 versus 111.5±36.2 ms, rMSSD 47.4±32.3 versus 55.2±35.2 ms; CPVI-S versus CPVI-R: SDNN 83.0±35.6 versus 101.0±40.7 ms, rMSSD 41.1±22.9 versus 59.2±44.8 ms; all P<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.http://dx.doi.org/10.1155/2013/569564 |
| spellingShingle | Kejing Wang Dong Chang Zhenliang Chu Yanzong Yang Lianjun Gao Shulong Zhang Yunlong Xia Yingxue Dong Xiaomeng Yin Peixin Cong Jingjing Jia Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation The Scientific World Journal |
| title | Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation |
| title_full | Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation |
| title_fullStr | Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation |
| title_full_unstemmed | Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation |
| title_short | Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation |
| title_sort | denervation as a common mechanism underlying different pulmonary vein isolation strategies for paroxysmal atrial fibrillation evidenced by heart rate variability after ablation |
| url | http://dx.doi.org/10.1155/2013/569564 |
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