TY - JOUR
T1 - Pulmonary Vein Denervation Enhances Long-Term Benefit after Circumferential Ablation for Paroxysmal Atrial Fibrillation
AU - Pappone, Carlo
AU - Santinelli, Vincenzo
AU - Manguso, Francesco
AU - Vicedomini, Gabriele
AU - Gugliotta, Filippo
AU - Augello, Giuseppe
AU - Mazzone, Patrizio
AU - Tortoriello, Valter
AU - Landoni, Giovanni
AU - Zangrillo, Alberto
AU - Lang, Christopher
AU - Tomita, Takeshi
AU - Mesas, Cézar
AU - Mastella, Elio
AU - Alfieri, Ottavio
PY - 2004/1/27
Y1 - 2004/1/27
N2 - Background-There are no data to evaluate the relationship between autonomic nerve function modification and recurrent atrial fibrillation (AF) after circumferential pulmonary vein ablation (CPVA). This study assesses the incremental benefit of vagal denervation by radiofrequency in preventing recurrent AF in a large series of patients undergoing CPVA for paroxysmal AF. Methods and Results-Data were collected on 297 patients undergoing CPVA for paroxysmal AF. Abolition of all evoked vagal reflexes around all pulmonary vein ostia was defined as complete vagal denervation (CVD) and was obtained in 34.3% of patients. Follow-up ended at 12 months. Heart rate variability attenuation, consistent with vagal withdrawal, was detectable for up to 3 months after CPVA, particularly in patients with reflexes and CVD, who were less likely to have recurrent AF than those without reflexes (P=0.0002, log-rank test). Only the percentage area of left atrial isolation and CVD were predictors of AF recurrence after CPVA (P
AB - Background-There are no data to evaluate the relationship between autonomic nerve function modification and recurrent atrial fibrillation (AF) after circumferential pulmonary vein ablation (CPVA). This study assesses the incremental benefit of vagal denervation by radiofrequency in preventing recurrent AF in a large series of patients undergoing CPVA for paroxysmal AF. Methods and Results-Data were collected on 297 patients undergoing CPVA for paroxysmal AF. Abolition of all evoked vagal reflexes around all pulmonary vein ostia was defined as complete vagal denervation (CVD) and was obtained in 34.3% of patients. Follow-up ended at 12 months. Heart rate variability attenuation, consistent with vagal withdrawal, was detectable for up to 3 months after CPVA, particularly in patients with reflexes and CVD, who were less likely to have recurrent AF than those without reflexes (P=0.0002, log-rank test). Only the percentage area of left atrial isolation and CVD were predictors of AF recurrence after CPVA (P
KW - Ablation
KW - Arrhythmia
KW - Atrium
KW - Fibrillation
KW - Nervous system, autonomic
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U2 - 10.1161/01.CIR.0000112641.16340.C7
DO - 10.1161/01.CIR.0000112641.16340.C7
M3 - Article
C2 - 14707026
AN - SCOPUS:9144239215
VL - 109
SP - 327
EP - 334
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 3
ER -