Skin sympathetic nerve activity in different ablation settings for atrial fibrillation

Chi Jen Weng, Cheng Hung Li, 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, Wei Tso Chen, Wen Han Chang, Nguyễn Khắc Thiên Chương, Ming Ren Kuo, Pei Heng Kao, Guan Yi LiIbrahim Ahliah, Shih Ann Chen*, Li Wei Lo*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Modifying the autonomic system after catheter ablation may prevent the recurrence of atrial fibrillation (AF). Evaluation of skin sympathetic nerve activity (SKNA) is a noninvasive method for the assessment of sympathetic activity. However, there are few studies on the effects of different energy settings on SKNA. Objective: To investigate the changes in SKNA in different energy settings and their relationship to AF ablation outcomes. Methods: Seventy-two patients with paroxysmal and persistent AF were enrolled. Forty-three patients received AF ablation with the conventional (ConV) energy setting (low power for long duration), and 29 patients using a high-power, short-duration (HPSD) strategy. The SKNA was acquired from the right arm 1 day before and after the radiofrequency ablation. We analyzed the SKNA and ablation outcomes in the different energy settings. Results: Both groups had a similar baseline average SKNA (aSKNA). We found that the median aSKNA increased significantly from 446.82 μV to 805.93 μV (p = 0.003) in the ConV group but not in the HPSD group. In the ConV group, patients without AF recurrence had higher aSKNA values. However, the 1-year AF recurrence rate remained similar between both groups (35 % vs. 28 %, p = 0.52). Conclusion: The post-ablation aSKNA levels increased significantly in the ConV group but did not change significantly in the HPSD group, which may reflect different neuromodulatory effects. However, the one-year AF recurrence rates were similar for both groups. These results demonstrate that the HPSD strategy has durable lesion creation but less lesion depth, which may reduce collateral damage.

Original languageEnglish
Pages (from-to)306-312
Number of pages7
JournalJournal of Cardiology
Volume83
Issue number5
DOIs
StatePublished - May 2024

Keywords

  • Atrial fibrillation
  • Autonomic system
  • High power short duration
  • Pulmonary vein isolation
  • Skin sympathetic nerve activity

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