The predictive value of heart rate variability indices tested in early period after radiofrequency catheter ablation for the recurrence of atrial fibrillation

Introduction To explore the relationship between recurrence of atrial fibrillation (AF) and the autonomic nervous activity evaluated by heart rate variability (HRV) indices after radiofrequency catheter ablation (RFCA) in the early period. Methods We enrolled 102 patients with paroxysmal AF and tested the HRV indices by the high‐resolution Holter electrocardiogram the next morning after RFCA. The HRV indices were compared between the non‐recurrence group (n = 85) and the recurrence group (n = 17). Results The HRV indices included standard deviation of normal to normal intervals (SDNN), SDNN index, root‐mean square successive differences (RMSSD), the proportion of normal to normal intervals differing by >50 millisecond (ms) (pNN50), high‐frequency components (HF), low‐frequency components (LF) and very low‐frequency components were significantly higher in recurrence group than that in non‐recurrence group, while no such difference was found for LF/HF. Based on the median value of the recurrent time (9 months), RMSSD ( P = .012), pNN50 ( P < .0001) and HF ( P = .033) were lower in late recurrence group than that in early recurrence group. The Cox regression analyses indicated that higher values of RMSSD ( P = .01), pNN50 ( P = .02) and HF ( P = .02) were associated with a higher risk of recurrence after adjusted for covariates. The receiver operating characteristic curves showed higher rates of clinical recurrence of AF after RFCA in patients with RMSSD ≥27.5 ms, pNN50 ≥4.5%, and HF ≥178.25 ms 2 . Conclusions Values of RMSSD, pNN50, and HF tested in the early period after RFCA could independently predict the recurrence of AF.