Long-term changes in heart rate variability after radiofrequency catheter ablation for atrial fibrillation: 1-year follow-up study with irrigation tip catheter

Ki Woon Kang, Tae Hoon Kim, Junebom Park, Jae Sun Uhm, Boyoung Joung, Chun Hwang, Moon Hyung Lee, Hui Nam Pak

Research output: Contribution to journalArticle

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Abstract

HRV After AF Ablation by Irrigation Tip Catheter Background Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) changes cardiac autonomic nerve activity. However, the long-term effect of RFCA has not yet been evaluated when an open irrigation tip catheter (OITC) was used. Therefore, we hypothesized that AF ablation changes heart rate variability (HRV) that would be maintained over 1 year after OITC ablation and be associated with clinical recurrence of AF. Methods and Results We analyzed pre-RFCA HRV (HRV pre), HRV at 3 months (HRV3mo) and 1 year (HRV 1yr) after RFCA using 24-hour Holter monitoring after excluding arrhythmic events in 144 patients (70% male, 57 ± 10 years old, 83% paroxysmal AF) who underwent RFCA with OITC. After RFCA with OITC, the increase in mean heart rate and the reduction in HF or LF/HF were significant at HRV 3mo (P < 0.001) and were maintained at HRV1yr (P < 0.001). During 20 ± 8 months of follow-up, 33 of 144 patients (23%) showed clinical recurrence of AF. Patients in the nonrecurrence group showed significant reductions of rMSSD and HF at HRV3mo and HRV 1yr, but patients with clinical recurrence did not. In Cox regression analysis, a reduction in LF/HF (&Delta;LF/HF) ≥0.26 at HRV3mo was significantly associated with clinical recurrence of AF (hazard ratio 2.52, 95% CI 1.19-5.32, P = 0.015). Conclusion In contrast to previous reports about long-term HRV recovery after AF ablation with a conventional catheter, change in cardiac autonomic nervous activity was maintained for 1 year after RFCA when an OITC was used. A reduction in &Delta;LF/HF ≥0.26 at HRV3mo was independently associated with clinical recurrence of AF after RFCA.

Original languageEnglish
Pages (from-to)693-700
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume25
Issue number7
DOIs
Publication statusPublished - 2014 Jul

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Catheter Ablation
Atrial Fibrillation
Catheters
Heart Rate
Recurrence
Autonomic Pathways
Ambulatory Electrocardiography
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{1f066b34eac24b9c8914dea6a93c0033,
title = "Long-term changes in heart rate variability after radiofrequency catheter ablation for atrial fibrillation: 1-year follow-up study with irrigation tip catheter",
abstract = "HRV After AF Ablation by Irrigation Tip Catheter Background Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) changes cardiac autonomic nerve activity. However, the long-term effect of RFCA has not yet been evaluated when an open irrigation tip catheter (OITC) was used. Therefore, we hypothesized that AF ablation changes heart rate variability (HRV) that would be maintained over 1 year after OITC ablation and be associated with clinical recurrence of AF. Methods and Results We analyzed pre-RFCA HRV (HRV pre), HRV at 3 months (HRV3mo) and 1 year (HRV 1yr) after RFCA using 24-hour Holter monitoring after excluding arrhythmic events in 144 patients (70{\%} male, 57 ± 10 years old, 83{\%} paroxysmal AF) who underwent RFCA with OITC. After RFCA with OITC, the increase in mean heart rate and the reduction in HF or LF/HF were significant at HRV 3mo (P < 0.001) and were maintained at HRV1yr (P < 0.001). During 20 ± 8 months of follow-up, 33 of 144 patients (23{\%}) showed clinical recurrence of AF. Patients in the nonrecurrence group showed significant reductions of rMSSD and HF at HRV3mo and HRV 1yr, but patients with clinical recurrence did not. In Cox regression analysis, a reduction in LF/HF (&Delta;LF/HF) ≥0.26 at HRV3mo was significantly associated with clinical recurrence of AF (hazard ratio 2.52, 95{\%} CI 1.19-5.32, P = 0.015). Conclusion In contrast to previous reports about long-term HRV recovery after AF ablation with a conventional catheter, change in cardiac autonomic nervous activity was maintained for 1 year after RFCA when an OITC was used. A reduction in &Delta;LF/HF ≥0.26 at HRV3mo was independently associated with clinical recurrence of AF after RFCA.",
author = "Kang, {Ki Woon} and Kim, {Tae Hoon} and Junebom Park and Uhm, {Jae Sun} and Boyoung Joung and Chun Hwang and Lee, {Moon Hyung} and Pak, {Hui Nam}",
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Long-term changes in heart rate variability after radiofrequency catheter ablation for atrial fibrillation : 1-year follow-up study with irrigation tip catheter. / Kang, Ki Woon; Kim, Tae Hoon; Park, Junebom; Uhm, Jae Sun; Joung, Boyoung; Hwang, Chun; Lee, Moon Hyung; Pak, Hui Nam.

In: Journal of Cardiovascular Electrophysiology, Vol. 25, No. 7, 07.2014, p. 693-700.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term changes in heart rate variability after radiofrequency catheter ablation for atrial fibrillation

T2 - 1-year follow-up study with irrigation tip catheter

AU - Kang, Ki Woon

AU - Kim, Tae Hoon

AU - Park, Junebom

AU - Uhm, Jae Sun

AU - Joung, Boyoung

AU - Hwang, Chun

AU - Lee, Moon Hyung

AU - Pak, Hui Nam

PY - 2014/7

Y1 - 2014/7

N2 - HRV After AF Ablation by Irrigation Tip Catheter Background Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) changes cardiac autonomic nerve activity. However, the long-term effect of RFCA has not yet been evaluated when an open irrigation tip catheter (OITC) was used. Therefore, we hypothesized that AF ablation changes heart rate variability (HRV) that would be maintained over 1 year after OITC ablation and be associated with clinical recurrence of AF. Methods and Results We analyzed pre-RFCA HRV (HRV pre), HRV at 3 months (HRV3mo) and 1 year (HRV 1yr) after RFCA using 24-hour Holter monitoring after excluding arrhythmic events in 144 patients (70% male, 57 ± 10 years old, 83% paroxysmal AF) who underwent RFCA with OITC. After RFCA with OITC, the increase in mean heart rate and the reduction in HF or LF/HF were significant at HRV 3mo (P < 0.001) and were maintained at HRV1yr (P < 0.001). During 20 ± 8 months of follow-up, 33 of 144 patients (23%) showed clinical recurrence of AF. Patients in the nonrecurrence group showed significant reductions of rMSSD and HF at HRV3mo and HRV 1yr, but patients with clinical recurrence did not. In Cox regression analysis, a reduction in LF/HF (&Delta;LF/HF) ≥0.26 at HRV3mo was significantly associated with clinical recurrence of AF (hazard ratio 2.52, 95% CI 1.19-5.32, P = 0.015). Conclusion In contrast to previous reports about long-term HRV recovery after AF ablation with a conventional catheter, change in cardiac autonomic nervous activity was maintained for 1 year after RFCA when an OITC was used. A reduction in &Delta;LF/HF ≥0.26 at HRV3mo was independently associated with clinical recurrence of AF after RFCA.

AB - HRV After AF Ablation by Irrigation Tip Catheter Background Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) changes cardiac autonomic nerve activity. However, the long-term effect of RFCA has not yet been evaluated when an open irrigation tip catheter (OITC) was used. Therefore, we hypothesized that AF ablation changes heart rate variability (HRV) that would be maintained over 1 year after OITC ablation and be associated with clinical recurrence of AF. Methods and Results We analyzed pre-RFCA HRV (HRV pre), HRV at 3 months (HRV3mo) and 1 year (HRV 1yr) after RFCA using 24-hour Holter monitoring after excluding arrhythmic events in 144 patients (70% male, 57 ± 10 years old, 83% paroxysmal AF) who underwent RFCA with OITC. After RFCA with OITC, the increase in mean heart rate and the reduction in HF or LF/HF were significant at HRV 3mo (P < 0.001) and were maintained at HRV1yr (P < 0.001). During 20 ± 8 months of follow-up, 33 of 144 patients (23%) showed clinical recurrence of AF. Patients in the nonrecurrence group showed significant reductions of rMSSD and HF at HRV3mo and HRV 1yr, but patients with clinical recurrence did not. In Cox regression analysis, a reduction in LF/HF (&Delta;LF/HF) ≥0.26 at HRV3mo was significantly associated with clinical recurrence of AF (hazard ratio 2.52, 95% CI 1.19-5.32, P = 0.015). Conclusion In contrast to previous reports about long-term HRV recovery after AF ablation with a conventional catheter, change in cardiac autonomic nervous activity was maintained for 1 year after RFCA when an OITC was used. A reduction in &Delta;LF/HF ≥0.26 at HRV3mo was independently associated with clinical recurrence of AF after RFCA.

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