Variability of baroreceptor reflex assessed by tilt table test in a patient undergoing pulmonary vein isolation
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Published:2023-11-13
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Volume:
Page:
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ISSN:1572-8595
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Container-title:Journal of Interventional Cardiac Electrophysiology
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language:en
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Short-container-title:J Interv Card Electrophysiol
Author:
Zuk Anna, Piotrowski RomanORCID, Sikorska Agnieszka, Kowalik Ilona, Kulakowski Piotr, Baran Jakub
Abstract
Abstract
Background
The autonomic nervous system (ANS) plays a significant role in atrial fibrillation (AF). Catheter ablation (CA) affects the ANS balance. The assessment of baroreceptor (BR) function is an established method to measure parasympathetic activity; however, it has been rarely used in patients undergoing CA of AF.
Aims
This study is to assess changes in BR function caused by CA and to compare these changes between two different types of CA: point-by-point radiofrequency (RF) versus cryoballoon (CB).
Methods
In this observational, prospective, single center study, 78 patients (25 females, mean age 58 ± 9) with paroxysmal AF and first CA were included: 39 patients (RF group) and 39 (CB group). The BR function was assessed non-invasively using tilt testing and three parameters: event count (BREC) depicting overall BR activity, slope mean depicting BR sensitivity (BRS), and BR effectiveness index (BEI).
Results
The groups did not differ in clinical or demographic data. Before CA, tilting caused a marked decrease in BR function parameters in the whole study group (BREC (29 ± 14.0–50.0 vs 28 ± 9.0–44.0, p < 0.068), BRS (10.2 ± 7.1–13.2 vs 5.8 ± 4.9–8.5; p < 0.001), and BEI (52.9 ± 39.9–65.5 vs 39.6 ± 23.6–52.1; p < 0.001), supine vs tilting, respectively). These changes were similar in the both groups. After CA, BR function decreased in the whole group (BREC 12.0 ± 3.0–22.0 vs 6.0 ± 3.0–18.0, p = 0.004; BRS 4.8 ± 3.6–6.8 vs 4.0 ± 3.0–5.8, p = 0.014; BEI 18.7 ± 8.3–27.4 vs 12.0 ± 5.1–21.0, p = 0.009). BREC was significantly more decreased in the CB vs RF. Similar trend was noted for BRS and BEI.
Conclusions
CA significantly affects BR function. These changes were more pronounced following CB rather than RF CA.
Funder
Centre of Postgraduate Medical Education, Warsaw, Poland
Publisher
Springer Science and Business Media LLC
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
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