Key result
Cryoballoon and hot-balloon based pulmonary vein isolation increased heart rate significantly compared to baseline, whereas radiofrequency ablation did not, despite all three methods ablating left atrial ganglionated plexi to a similar extent.
Why the study?
Modulation of the intrinsic cardiac autonomic nervous system occurs after RF PVI for AF, but the effects of CB and HB ablation have not been evaluated.
Does cryoballoon or hot-balloon pulmonary vein isolation affect the cardiac autonomic nervous system differently compared to radiofrequency ablation in patients with atrial fibrillation?
Observational (n=65)
Yes
Does cryoballoon or hot-balloon pulmonary vein isolation affect the cardiac autonomic nervous system differently compared to radiofrequency ablation in patients with atrial fibrillation?
Balloon-based pulmonary vein isolation (cryoballoon and hot-balloon) results in a significantly greater acute increase in heart rate compared to radiofrequency ablation, despite similar effects on vagal responses, suggesting differences in autonomic nervous system modulation.
Answers are grounded in this paper and cite their sources.
Balloon PVI linked to greater heart rate rise than RF; leaves open differential autonomic effects requiring randomized confirmation.
Background: Modulation of the intrinsic cardiac autonomic nervous system (ICANS) can occur after radiofrequency (RF) pulmonary vein isolation (PVI) for atrial fibrillation (AF). However, the effects of cryoballoon (CB) ablation and hot-balloon (HB) based PVI on the ICANS have not been evaluated. We compared the acute periprocedural effects on the ICAVS, as well as changes in heart rate variability (HRV) between RF-, CB-and HB-based PVI.
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Watanabe et al. (2019) conducted an observational in Atrial fibrillation (n=65). Cryoballoon and hot-balloon ablation vs. Radiofrequency ablation was evaluated on Proportion of left atrial ganglionated plexi ablated (p=0.5018). Cryoballoon and hot-balloon based pulmonary vein isolation increased heart rate significantly compared to baseline, whereas radiofrequency ablation did not, despite all three methods ablating left atrial ganglionated plexi to a similar extent.
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