Zarębski Łukasz, Futyma Piotr
St. Joseph's Heart Rhythm Center, Anny Jagiellonki 17, 35-623, Rzeszów, Poland.
University of Rzeszów, Rzeszów, Poland.
J Interv Card Electrophysiol. 2025 Mar;68(2):455-464. doi: 10.1007/s10840-024-01899-4. Epub 2024 Aug 20.
Subtypes of atrial fibrillation (AF) can differ, and exact mechanisms in which patients benefit from the pulmonary vein isolation (PVI) remain not fully understood. During PVI, vagal innervation of the heart may also be affected. Thus, non-invasive methods of intraprocedural assessment of such PVI impact are sought.
From 1-minute ECG recordings performed before and after PVI, we investigated short-term deceleration capacity (ST-DC) and short-term heart rate variability (ST-HRV) to determine their potential as indicators of parasympathetic activity before and after ablation.
In 24 consecutive patients with paroxysmal AF included in the study, there were a significant differences in ST-DC and ST-HRV parameters measured before and after PVI. After 3 months, patients with baseline ST-DC ≥ 7.5 ms were less likely to experience AF recurrence when compared to patients with baseline ST-DC < 7.5 ms (0% vs 31%, p = 0.0496). There were no differences in AF recurrence after 12 months of follow-up (36% vs 38%, p = 0.52).
PVI leads to significant changes in ST-DC and ST-HRV, and these parameters can serve as indicators of vagal denervation after AF ablation. Patients with more prominent baseline ST-DC are less likely to experience AF recurrence during the post-PVI 3-month blanking period.
心房颤动（AF）的亚型有所不同，患者从肺静脉隔离（PVI）中获益的确切机制仍未完全明确。在进行PVI时，心脏的迷走神经支配也可能受到影响。因此，人们正在寻找对这种PVI影响进行术中评估的非侵入性方法。
通过对PVI前后记录的1分钟心电图，我们研究了短期减速能力（ST-DC）和短期心率变异性（ST-HRV），以确定它们作为消融前后副交感神经活动指标的潜力。
在该研究纳入的24例阵发性AF连续患者中，PVI前后测量的ST-DC和ST-HRV参数存在显著差异。3个月后，与基线ST-DC＜7.5 ms的患者相比，基线ST-DC≥7.5 ms的患者发生AF复发的可能性较小（0%对31%，p = 0.0496）。随访12个月后AF复发情况无差异（36%对38%，p = 0.52）。
PVI导致ST-DC和ST-HRV发生显著变化，这些参数可作为AF消融后迷走神经去神经支配的指标。基线ST-DC更显著的患者在PVI后3个月空白期内发生AF复发的可能性较小。
