Alterations of heart rate turbulence and immediate vagal reflex during left atrium circumferential pulmonary vein ablation / 中国介入心脏病学杂志

ABSTRACT

Objective To observe the alteration of heart rate turbulence(HRT) before and after left atrium circumferential ablation surrounding pulmonary veins(LACA) in patients with paroxysmal atrial fibrillation(PAF) in order to determine whether concealed vagal denervation occurred during the procedure.Methods Forty-four patients(26 male,aged 53?11 years) with paroxysmal atrial fibrillation who had received catheter ablation treatment from Mar 2006 to Dec 2006 were included in the study.The mean diameter of left atrium was 36?5 cm and the mean ejection fracion was 0.65?0.04 in these patients.The left atrium circumferential ablation surrounding pulmonary veins were performed in all the patients to achieve complete electrical isolation of both ipsilateral pulmonary veins.RS2 extrastimulus were delivered from right ventricular apex to obtain heart rate turbulence with 60% of basic sinus cycle length and at twice diastolic threshold before and after the procedure.Turbulence onset(TO)(%) and turbulence slope(TS)(msec/beat) were obtained using average five respective ventricular premature beats.Thirty-seven patients who had received catheter ablation of supraventricular tachycardia were included as control.Results There was no significant difference between AF and control group in HRT [TO-0.021 6%?0.023 6% vs-0.023 6%?0.018 5%(P=0.67);TS 7.331 8?6.983 5 vs 9.667 9?6.065 2(P=0.12)].TO and TS changed significantly after LACA [-0.021 6?0.023 6 to 0.000 9?0.013 3(P