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High frequency stimulation of the atria increases early recurrence following pulmonary vein isolation in patients with persistent atrial fibrillation.
MedLine Citation:
PMID:  22583843     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: High frequency stimulation of the atria (HFS) induces atrial fibrillation (AF) when applied during sinus rhythm and elicits a parasympathetic response when delivered at sites where ganglionated plexi (GPs) are located. However, little is known about its impact after an electrophysiological study. Objective We aimed to evaluate the impact of HFS on the short-term and long-term outcomes after ablation of persistent AF. METHODS: Thirty consecutive patients with persistent or longstanding persistent AF were randomly assigned to either receive HFS of the left atrium (LA) (n = 15), or not (n = 15) during their electrophysiological studies. Patients receiving HFS were examined to determine whether or not a vagal response was elicited by the HFS at sites where GPs were located before and after conventional pulmonary vein (PV) isolation without any ablation targeting the GPs. Patients not receiving the HFS only underwent the ablation procedure. The rate of recurrence of AF within 3 months of the procedure (early recurrence [ER]), and the frequency of that occurring after that period (late recurrence [LR]), were compared between the patient groups. RESULTS: The incidence of ER occurred more frequently in patients with HFS than in those without (80% vs. 40%; p = 0.015), whereas the occurrence of LR was similar between the two groups (27% vs. 33%; p = 0.73). In the HFS group, the number of GPs decreased from 3.5 ± 1.1 to 1.6 ± 0.9 after the PV isolation (p <0.0001), and the decrease was smaller in the patients experiencing ER than in those without. CONCLUSION: HFS increases the incidence of ER in patients with persistent AF despite a partial GP modification resulting from the PV isolation.
Authors:
Akinori Sairaku; Yukihiko Yoshida; Hiroki Kamiya; Yasushi Tatematsu; Mamoru Nanasato; Haruo Hirayama; Yukiko Nakano; Yasuki Kihara
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-11
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
Affiliation:
Department of Cardiology, Cardiovascular Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan; Department of Cardiology, Hiroshima University, Hiroshima, Japan.
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