Cardiac Denervation After Radiofrequency Ablation of Supraventricular Tachycardias

Inappropriate sinus tachycardia and atrial arrhythmias have been reported after radiofrequency ablation. Previous studies have suggested that cardiac denervation is a possible explanation for these rhythm disturbances. The aim of this study was to investigate possible alterations in autonomic innerv...

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Bibliographic Details
Published in:The American journal of cardiology 1998-03, Vol.81 (6), p.725-731
Main Authors: Psychari, Stavroula N, Theodorakis, George N, Koutelou, Maria, Livanis, Efthimios G, Kremastinos, Dimitrios Th
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cardiology
Catheter Ablation - adverse effects
Diseases of the cardiovascular system
Electrocardiography, Ambulatory
Electrophysiology
Female
Heart - innervation
Heart Conduction System
Heart Rate
Humans
Male
Medical sciences
Radio frequency
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Tachycardia, Supraventricular - physiopathology
Tachycardia, Supraventricular - surgery
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Summary:Inappropriate sinus tachycardia and atrial arrhythmias have been reported after radiofrequency ablation. Previous studies have suggested that cardiac denervation is a possible explanation for these rhythm disturbances. The aim of this study was to investigate possible alterations in autonomic innervation of the heart after ablation using the techniques of heart rate variability (HRV) analysis and metaiodobenzylguanidine (I-123 MIBG) scintigraphy. The subjects of this study were 30 consecutive patients aged 25 to 40 years, without structural heart disease, who underwent radiofrequency ablation of atrioventricular nodal slow pathways, and posteroseptal and left lateral accessory pathways because of symptomatic recurrent reentrant tachycardias. Time and frequency domain analysis of HRV after ablation revealed a significant reduction in the indexes of the mean of all 5-minute standard deviation of RR intervals (p = 0.042), low frequency (p = 0.0005), and total frequency (p = 0.008) compared with preablation values in the group of patients who underwent atrioventricular nodal slow pathway ablation. Patients who underwent ablation of a posteroseptal accessory pathway also had significant attenuation of the indexes of standard deviation about the mean RR interval (p = 0.03), standard deviation of 5-minute mean RR intervals (p = 0.006), and low-frequency (p
ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(97)01008-4