Περίληψη:
Aims Vagal responses (VR) during left atrial ablation for atrial
fibrillation (AF) treatment have been reported to be associated with
less recurrences, presumably because they are a sign of ganglionated
plexi modification. Our objective was to evaluate whether coincidentally
elicited VR during left atrial ablation are associated with lower AF
recurrence rates.
Methods and results This is a post hoc analysis of a prospective study
of 291 patients with paroxysmal AF undergoing radiofrequency pulmonary
vein isolation (PVI). Vagal responses were defined as episodes of heart
rate <40 bpm or asystole lasting >5 s elicited during energy
application. Sixty-eight patients (23.4%) had a VR during ablation. In
Kaplan-Meier analysis, mean recurrence-free survival was 449 days (95%
confidence interval 411-488) in patients with VR when compared with 435
days (95% confidence interval 415-455) in those without (P = 0.310).
The 12-month recurrence rate estimates were 25 and 27%, respectively.
In an unadjusted Cox model, VR was associated with an odds ratio for
recurrence of 0.77 (95% confidence interval 0.46-1.28).
Conclusion Coincidentally elicited VR during radiofrequency PVI in
patients with paroxysmal AF do not appear to be related to lower risk of
arrhythmia recurrence. This may mean that, even if a VR is truly a sign
of coincidental ablation of a ganglionated plexus, this does not
necessarily mean that a therapeutic modification has been effected, at
least to a degree associated with clinical benefit.
Συγγραφείς:
Giannopoulos, Georgios
Kossyvakis, Charalampos
Angelidis,
Christos
Panagopoulou, Vasiliki
Tsiachris, Dimitrios and
Vrachatis, Dimitrios A.
Doudoumis, Konstantinos
Letsas,
Konstantinos
Pagoni, Stamatina
Stefanadis, Christodoulos and
Vassilikos, Vassilios P.
Lekakis, John
Deftereos, Spyridon
