Low heart deceleration capacity imply higher atrial fibrillation-free rate after ablation

Abstract

How deceleration capacity (DC) and acceleration capacity (AC) of heart rate associated with atrial fibrillation (AF) and ablation is still not clear. The dynamic changes of AC, DC and conventional heart rate variability (HRV) parameters were characterized in 154 subjects before circumferential pulmonary veins isolation (CPVI) and three days, 3 months and 6 months after CPVI. The DCs of the recurrent group decreased significantly at each time point after CPVI; the DCs of the recurrence-free group before CPVI and three days, 3 months and 6 months after CPVI were 7.06 ± 1.77, 3.79 ± 1.18, 4.22 ± 1.96 and 3.97 ± 0.98 ms respectively, which also decreased significantly at each time point and were significantly lower than these of recurrent group. Conversely, the AC of recurrent and recurrence-free groups increased significantly at each time point after CPVI; the ACs of recurrence-fee group were significantly higher than these of recurrent group at each time point. No stable difference trend of HRV parameters was found between two groups. Further Kaplan-Meier analysis showed that DC < 4.8 ms or AC ≥ -5.1 ms displayed significant higher recurrence-free rates. In conclusion, high AC and low DC imply higher AF-free rate after ablation.

Figure 1

Study flowchart of patient selection. AF, atrial fibrillation; CPVI, circumferential pulmonary vein isolation.

Figure 2

The change tendency of each index before and after CPVI of the recurrence-free and recurrence groups. *indicates the significance at each time point after CPVI when compared with that before CPVI. #indicates the significance at a time point between recurrence-free group and recurrence group. For abbreviation, please see Table 1 or Table 2.

Figure 3

Kaplan–Meier analysis of AF recurrence-free rate according to AC and DC. A. Recurrence-free rates in 6 months follow-up of DC < 4.8 ms vs. DC ≥ 4.8 ms. B. Recurrence-free rate in 6 months follow-up of AC ≥ −5.1 ms vs. AC < −5.1 ms.