Alteration of Skin Sympathetic Nerve Activity after Pulmonary Vein Isolation in Patients with Paroxysmal Atrial Fibrillation

Wei Ting Sung, Li Wei Lo*, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Fa Po Chung, Jo Nan Liao, Ta Chuan Tuan, Tze Fan Chao, Chin Yu Lin, Ting Yung Chang, Ling Kuo, Chih Min Liu, Shin Huei Liu, Wen Han Cheng, An Khanh Nu Ton, Chu Yu Hsu, Chheng Chhay, Ahmed Moustafa Elimam, Ming Jen KuoPei Heng Kao, Wei Tso Chen, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Autonomic system plays a pivotal role in the pathogenesis of paroxysmal atrial fibrillation (AF). Skin sympathetic nerve activity (SKNA) is a noninvasive tool for assessing sympathetic tone. However, data on changes in SKNA after ablation are limited. Here, we retrospectively enrolled 37 patients with symptomatic drug-refractory paroxysmal AF who underwent pulmonary vein isolation (PVI) with radiofrequency ablation (RFA) or cryoablation (CBA). SKNA was measured from the chest and right arm 1 day prior to ablation, as well as 1 day and 3 months after ablation. One day after ablation, the SKNA-Arm increased from 517.1 µV (first and third quartiles, 396.0 and 728.0, respectively) to 1226.2 µV (first and third quartiles, 555.2 and 2281.0), with an increase of 179.8% (125% and 376.0%) (p < 0.001); the SKNA-Chest increased from 538.2 µV (first and third quartiles, 432.9 and 663.9) to 640.0 µV (first and third quartiles, 474.2 and 925.6), with an increase of 108.3% (95.6% and 167.9%) (p = 0.004), respectively. In those without recurrence, there was a significant increase in SKNA 1 day after ablation as compared with those before ablation. Twelve patients received SKNA measurement 3 months after ablation; both SKNA-Arm (p = 0.31) and SKNA-Chest (p = 0.27) were similar to those before ablation, respectively. Among patients with symptomatic drug-refractory paroxysmal AF receiving PVI, increased SKNA was observed 1 day after ablation and returned to the baseline 3 months after ablation. Elevation of SKNA was associated with lower early and late recurrences following ablation.

Original languageEnglish
Article number1286
JournalJournal of Personalized Medicine
Issue number8
StatePublished - Aug 2022


  • atrial fibrillation
  • autonomic system
  • pulmonary vein isolation
  • skin sympathetic nerve activity


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