Evaluation of heart rate variability at 1-month after pulsed field ablation of atrial fibrillation and comparison with radiofrequency ablation

Abstract Background Pulsed Field Ablation (PFA) of atrial fibrillation (AF) is a nonthermal novel ablative modality in which high-voltage electric pulses are delivered to generate a high myocardial tissue-specific cellular death, with negligible consequences on surrounding structures including gangl...

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Published in:Europace (London, England) England), 2024-05, Vol.26 (Supplement_1)
Main Authors: Vio, R, Forlin, E, Quinto, L, Vitale, R, Marras, E, Corrado, A, Themistoclakis, S, China, P
Format: Article
Language:English
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Summary:Abstract Background Pulsed Field Ablation (PFA) of atrial fibrillation (AF) is a nonthermal novel ablative modality in which high-voltage electric pulses are delivered to generate a high myocardial tissue-specific cellular death, with negligible consequences on surrounding structures including ganglionated plexi. The impairment of the cardiac autonomic ganglia after AF ablation with radiofrequency (RF) has been associated with an increase in mean heart rate (HR) and a reduction in heart rate variability (HRV) and might influence the long-term success of AF ablation. Little data is available on the effect of PFA on cardiac autonomic nervous function. Purpose The aim of this study is to investigate whether PFA ablation could lead to different values of HR and HRV compared to RF at 1-month post-ablation 24-hour Holter monitoring. Methods Between January to September 2023, we included consecutive patients undergoing AF ablation with PFA. According to our clinical practice, all patients performed a routine 24-hour Holter monitoring at 1-month post-ablation. Consecutive AF patients treated with RF were used as controls. Patients in treatment with antiarrhythmics or with documented recurrences of AF at 1-month post-ablation Holter monitoring were excluded. Results 22 consecutive PFA patients were compared to 22 consecutive RF controls. There were no differences in demographic, clinical and echocardiographic data between the 2 groups (Table 1). At 1-month post-ablation Holter monitoring (Table 2), PFA patients had significant higher values of VarIndex (2.18±0.9 vs 1.47±0.7, p=0.01), ASDNN/5min (52.37±15.93 vs 37.17±12.96, p
ISSN:1099-5129
1532-2092
DOI:10.1093/europace/euae102.217