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Different time course effect of autonomic nervous modulation after cryoballoon and hotballoon catheter ablations for paroxysmal atrial fibrillation

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Abstract

Background

Few studies have reported on the quantitative evaluation of autonomic nerve modification after balloon ablation. Therefore, this study aimed to evaluate the effects of cryoballoon and hotballoon ablations on the autonomic nervous system (ANS) and their relationship with prognosis.

Methods

We included 234 patients who underwent cryoballoon ablation (n = 190) or hotballoon ablation (n = 44) for paroxysmal atrial fibrillation. Heart rate variability (HRV) analysis was performed on all patients using a 3-min electrocardiogram at baseline, 1, 3, 6, and 12 months after ablation. HRV parameters and prognoses were compared between the two balloon systems.

Results

Ln low-frequency (LF), Ln high-frequency (HF), standard deviation of the R-R intervals (SDNN), and RR intervals significantly decreased after 1 month in both groups, but the changes were more pronounced in the cryoballoon group than in the hotballoon group. In contrast, HRV indices in the hotballoon ablation group decreased gradually and reached their lowest point 3-to-6 months after the procedure, which was later than in the cryoballoon ablation group. The recurrence rate did not differ between the two groups. HRV parameters changed similarly in the cryoballoon group, regardless of recurrence. However, patients with recurrence had significantly higher SDNN and Ln LF at 12 months than those without recurrence in the hotballoon group (41.2 ± 39.3 ms vs. 18.5 ± 12.6 ms, p = 0.006, and 2.2 ± 0.7 ms2 vs. 1.5 ± 0.7 ms2, p = 0.003, respectively).

Conclusions

The time course of HRV changes differed between cryoballoon and hotballoon ablations. Hence, the two balloon systems may have distinct effects on the ANS and its role in prognosis.

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Acknowledgements

The authors thank all medical and clinical engineering staff at Nagoya University for their assistance during the ablation procedure. We also acknowledge Naoto Yoshida (APEX, Inc.) and Takahiro Nagase (Toray Medical Japan) for their excellent support in setting the experiment model, delivering a lecture on the ballooning mechanism, and arranging the balloon catheters.

Funding

This study was funded by Medtronic Japan and Grant-in-Aid for Young Scientists 19K17558.

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Authors and Affiliations

  1. Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan

    Noriyuki Suzuki, Yasuya Inden, Satoshi Yanagisawa, Yuuki Shimizu, Shingo Narita, Kei Hiramatsu, Ryota Yamauchi, Ryo Watanabe, Naoki Tsurumi, Masafumi Shimojo, Kazumasa Suga, Yukiomi Tsuji, Rei Shibata & Toyoaki Murohara

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  1. Noriyuki Suzuki
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Correspondence to Satoshi Yanagisawa.

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Ethics approval and consent to participate

This study was approved by the local institutional ethics committee of Nagoya University Hospital. All patients provided written informed consent prior to the procedure.

Conflict of interest

Drs. Yanagisawa and Shibata belong to an endowed department sponsored by Medtronic Japan Co., Ltd. Drs. Shimojo and Tsuji are affiliated with a department sponsored by Japan Lifeline Co., Ltd., BIOTRONIK Japan, Inc., FUKUDA DENSHI Co., Ltd., and SUZUKEN Co., Ltd.

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Suzuki, N., Inden, Y., Yanagisawa, S. et al. Different time course effect of autonomic nervous modulation after cryoballoon and hotballoon catheter ablations for paroxysmal atrial fibrillation. J Interv Card Electrophysiol (2023). https://doi.org/10.1007/s10840-023-01581-1

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