Fi̇li̇z Kızılırmak Yılmaz1, Fatih Yilmaz2, Arzu Yıldırım1, Hacı Murat Güneş1, Tayyar Gökdeniz3, Fatih Erkam Olgun1, Tugba Aktemur1, Ümeyi̇r Savur4, Fethi Kılıçaslan1

1Medipol University Faculty of Medicine, Cardiology Department, Istanbul, Turkey, Cardiology, Istanbul, Turkey
2Kartal Kosuyolu Research and Education Hospital , Cardiology, Istanbul, Turkey
3Hitit University Faculty of Medicine, Cardiology Department, Corum, Turkey, Cardiology, Çorum, Turkey
4Gaziosmanpaşa Research and Education Hospital, Cardiology, Istanbul, Turkey

Keywords: Autonomic nervous system activity, atrial fibrillation, catheter ablation

Abstract

Objectives: In this study, we aimed to investigate the relationship between autonomic dysfunction (AD) determined according to the blood pressure (BP) and heart rate (HR) response in exercise treadmill test (ETT) prior to cryoballoon ablation (CBA), and the recurrence of atrial fibrillation (AF) after CBA in patients with paroxysmal AF.

Patients and Methods: Seventy-six patients (mean age 53±11 years, 61.8% male) with paroxysmal AF who underwent CBA were enrolled. Before CBA the ETT was performed by all patients. BP and HR response in ETT were compared between patients with and without AF recurrence.

Results: AD rate was significantly higher in the group with recurrence compared to the non- recurrent group (p<0.001). In addition to AD, age, female gender and lower exercise capacity were also associated with post-CBA AF recurrence ( p>0.05 for all ). Examining AD parameters, systolic blood pressure at peak exercise (SBPpeak) (p<0.001) and diastolic blood pressure at peak exercise (DBPpeak) (p<0.001), slow heart rate recovery (HRR) (p<0.001) were significantly higher in the recurrent group.

Conclusion: AD may associated with AF recurrence after CBA in patients with paroxysmal AF. SBPpeak, DBPpeak and slow HRR appear to be predictors of AF recurrence after ablation.