1. Heart rate increase and inappropriate sinus tachycardia after cryoballoon pulmonary vein isolation for atrial fibrillation
- Author
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Michiel Rienstra, Yuri Blaauw, Eng S. Tan, Ans C.P. Wiesfeld, C van Deutekom, Robert G. Tieleman, H F Groenveld, I. C. Van Gelder, Bart A. Mulder, and Cardiovascular Centre (CVC)
- Subjects
medicine.medical_specialty ,Heart rate ,GANGLIONATED PLEXI ,Cryoballoon ,Pulmonary vein isolation ,MECHANISMS ,Pulmonary vein ,Internal medicine ,ABLATION ,medicine ,Sinus rhythm ,Sinus (anatomy) ,RISK ,business.industry ,Atrial fibrillation ,AUTONOMIC NERVOUS-SYSTEM ,medicine.disease ,Inappropriate sinus tachycardia ,Autonomic nervous system ,medicine.anatomical_structure ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Holter monitoring ,circulatory and respiratory physiology - Abstract
Background Cryoballoon pulmonary vein isolation (PVI) is a common therapy for atrial fibrillation (AF). While moderately increased sinus rhythm heart rate (HR) after PVI has been observed, inappropriate sinus tachycardia (IST) is a rare phenomenon. We aimed to investigate the prevalence and natural history of an abnormal sinus HR response after cryoballoon PVI. Methods We included 169/646 (26.2%) patients with AF undergoing PVI with available Holter recordings before and 3, 6 and 12 months after the procedure. Patients with AF on Holter monitoring were excluded. Mean HR increase ≥ 20 bpm or an IST-like pattern (mean HR > 90 bpm or > 80 bpm when beta-blocking agents were used) following PVI was categorised as abnormal sinus HR response. Results Following PVI, mean HR ± standard deviation increased in the entire group from 63.5 ± 8.4 to 69.1 ± 9.9 bpm at 3 months (p p p p = 0.033). However, in patients meeting IST-like pattern criteria, mean HR at 12 months was no longer significantly different from that pre-ablation. Conclusion Few patients had an abnormal sinus HR response after PVI. Peak HR was observed 3 months after PVI, but HR was still significantly increased 12 months post-ablation compared with pre-ablation. An IST-like pattern was rarely observed. In these patients, HR decreased to pre-ablation values within a year.
- Published
- 2021