Effect of Radiofrequency Current Application during Catheter Ablation on Heart Rate Variability in Patients with Supraventricular Tachycardia
Nashaat Lotfy, Emad Effat, Rania Samir, Hayam Eldamnhoury- General Medicine
Abstract
Background
The autonomic nervous system has a significant regulatory effect on heart function; in addition to heart rate, cardiac conduction properties, hemodynamics, the cellular properties of cardiac myocytes, and cardiac arrhythmogenesis are also affected by the autonomic nervous system.
Objectives
In this study, we aimed to assess the Relationship between RF current application during Catheter ablation and it's effect on Heart Rate variability in patients undergoing RF catheter ablation for supraventricular Tachycardia.
Patients and Methods
This study is a cohort study, randomized clinical study, recruiting 20 patients from Ain Shams University hospitals, Cairo, Egypt. All patients were symptomatic with drug refractory documented supraventricular tachycardias. who underwent RF ablation March 2020 till February 2021 and were followed up for 1 month after the procedure.
Results
Compared with preablation data, HRV were shorter in all the RFA at the follow-up assessment. The 24-h Holter monitoring showed that mean and maximal HR were increased, whereas the HRV parameters, including time domain indices (SDNN, rMSSD) and frequency domain index, which reflect the attenuation of parasympathetic tone, were decreased in the RFA during the postablation period. In this study, there was significant increasing in mean heart rate regarding basal and the subsequent follow up after 1 week and 1 month. Post ablation high sinus rate (PA-HSR) was defined as an increase in resting sinus rate > or = 20 bpm or a resting sinus rate > or = 92 bpm without physiological or hemodynamic causes. In this study PAHSR was found in 10 patients (50%) by month-1 follow up. There is relation between the target site of RF ablation and the difference of HRV parameters.
Conclusion
Cardiac autonomic dysfunction assessed by changes in time domain and frequency domain heart rate variability parameters persisted for 1 month after radiofrequency ablation. Parasympathetic denervation may be one mechanism of Post ablation high sinus rate.