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Background It has been reported that atrial fibrillation (AF) may contribute to impairment of baroreflex sensitivity (BRS). However, the difference of BRS between patients with persistent AF (PeAF) and those with paroxysmal AF (PAF) is unknown. We tested the hypothesis that patients with PeAF have a more impaired BRS compared with those with PAF. Methods and Results From October 2015 onwards, a total of 67 patients (14 women [20.9%]; mean age 65.2±10.1 years) with PAF (n=46, 68.7%) and PeAF (n=21, 31.3%), who underwent catheter ablation, were prospectively enrolled. The baseline BRS was evaluated during sinus rhythm. The baseline BRS in patients with PeAF was significantly lower than those with PAF (2.97 [0.52-6.62] ms/mm Hg versus 4.70 [2.36-8.37] ms/mm Hg, =0.047). The BRS was significantly depressed after catheter ablation in all the patients (4.66 [1.80-7.37] ms/mm Hg versus 0.55 [-0.15 to 1.22] ms/mm Hg, <0.001). However, the depression of BRS because of catheter ablation appeared attenuated in patients with PeAF when compared with those with PAF. The number of patients who did not show depression of BRS was significantly greater, that is, patients with PeAF (3/12, 25%) than those with PAF (0/46, 0%, <0.01). Conclusions Our findings demonstrated that the baseline BRS was more depressed in patients with PeAF compared with PAF. Catheter ablation depressed BRS irrespective of the type of AF, with a greater effect in patients with PAF than PeAF.

背景

据报道，心房颤动（AF）可能导致压力反射敏感性（BRS）受损。然而，持续性 AF（PeAF）和阵发性 AF（PAF）患者之间的 BRS 差异尚不清楚。我们检验了这样一个假设，即 PeAF 患者的 BRS 受损程度比 PAF 患者更严重。

方法和结果

从 2015 年 10 月开始，前瞻性纳入了 67 例接受导管消融术的患者（女性 14 例[20.9%]；平均年龄 65.2±10.1 岁），其中 PAF 患者 46 例（68.7%），PeAF 患者 21 例（31.3%）。窦性心律下评估基线 BRS。PeAF 患者的基线 BRS 明显低于 PAF 患者（2.97[0.52-6.62]ms/mm Hg 比 4.70[2.36-8.37]ms/mm Hg，=0.047）。所有患者在导管消融后 BRS 均明显下降（4.66[1.80-7.37]ms/mm Hg 比 0.55[-0.15 至 1.22]ms/mm Hg，<0.001）。然而，与 PAF 患者相比，PeAF 患者的 BRS 下降幅度较小。未出现 BRS 下降的患者比例明显更高，即 PeAF 患者（3/12，25%）多于 PAF 患者（0/46，0%，<0.01）。