Premium
Preserved Autonomic Modulation of the Sinus and Atrioventricular Nodes Following Posteroseptal Ablation for Treatment of Atrioventricular Nodal Reentrant Tachycardia
Author(s) -
KOWALLIK PETER,
ESCHER SILKE,
PETERS WERNER,
BRAUN CHRISTIAN,
MEESMANN MALTE
Publication year - 1998
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1998.tb00936.x
Subject(s) - medicine , cardiology , ablation , tachycardia , radiofrequency ablation , catheter ablation , atrioventricular node , coronary sinus , sinoatrial node , anesthesia , heart rate , blood pressure
Autonomic Control of the AV Node. Introduction : Following radiofrequency catheter ablation of AV nodal reentrant tachycardia (AVNRT), inappropriate sinus tachycardia may occur, possibly due to damage to autonomic cardiac nerve fibers. Furthermore, inducibility of AVNRT is often critically dependent on the autonomic balance. We investigated whether successful ablation of AVNRT is associated with an alteration of autonomic input to the sinus and AV nodes. Methods and Results : To estimate changes in the automatic modulation of the sinus and AV nodes, power spectra of beat‐to‐beat PP and PR intervals were analyzed from high‐quality nighttime ECG recordings of 11 patients before and after radiofrequency application. Normalized HF power (nHF) of PP and PR intervals was used as an index of efferent vagal modulation and the LF/HF ratio as an index of sympathovagal balance of the sinus node (PP) and AV node (PR). Before ablation, LF/HF PP was 3.2 and nHF PP was 0.3 in the sinus node, For the A/V node, LF/HF PR was 1.2 and nHF PR was 0.5. Following ablation. LF/HF PP (3.5) and nHF PP (0.3) of the PP intervals did not change. Similarly to the sinus node, there were no changes in the autonomic modulation of the AV node, as both LF/HF PR (1.2) and nHF PR (0.5) remained unchanged. Conclusion : Our results indicate that autonomic control of the sinus und AV nodes is preserved following successful radiofrequency ablation of AVNRT. The effects of posteroseptal radiofrequency current application are not necessarily mediated by changes in the autonomic input to the AV node.