Can we say anything about ganglionated plexus modification during radiofrequency pulmonary vein isolation and post-ablation arrhythmia recurrence at this time?

In this study, the authors evaluated whether coincidentally elicited vagal response (VR) during left atrial ablation are associated with lower atrial fibrillati on recurrence rates. Heart rate <40 bpm or asystole lasting  >5  s elicited during or immediately after radiofrequency (RF) energy application were defined as VR. We would like to take attention some issues related to the article. Firstly, the authors might use a little bit more specific cut-off values for the definition of VR. It is well known that basal hear t rate of the patients may be very different at the beginning of the procedure. For example, heart rate of 70 bpm during RF application may be accepted as a VR if pre-procedural is greater than 120 bpm. So, a progressive slowing of the sinus rate by 50% may become a more realistic indicator of VR. S econdly, to discuss whether ganglionated plexus (GP) modification affects atrial fibrillation recurrence rates, the authors should discuss some data about post-procedural changes on basal electrophysiological parameters. In our research article, we demonstrated a significant decrease on basal cycle lengths and atrioventricular Wenckebach points after the procedure in patients with reflex syncope.2 Also, it is well known that long-term durability of vagal denervation might be investigated by Holter recordings. It was demonstrated by our group that vagal denervation may cause a significant increase in minimum and mean heart rates during 6-months follow-up.2
Source: Europace - Category: Cardiology Source Type: research