Delayed injury of autonomic nerve induced by radiofrequency catheter ablation.
OBJECTIVE
Radiofrequency catheter ablation (RFCA) is the curative treatment of choice for many cardiac arrhythmias and may cause myocardial injury and inappropriate sinus tachycardia. This study aimed to determine the delayed injury of autonomic nerve after RFCA.


METHODS
Spectral analysis of heart rate variation on 24-hour Holter electrocardiogram recordings was carried out in 86 cases (39 women, 47 men; mean age, 42 years; range, 17-67 years) with paroxysmal supraventricular tachycardia 1 hour before and 1 year after successful RFCA (WPW type A = 31; Wolf-Pakinson-White Syndrome type B = 9; atrioventricular [AV] nodal tachycardia = 46; group A: septal accessory pathway + AV nodal tachycardia [n = 52], group B: free wall accessory pathway [n = 34]).


RESULTS
Heart rate variation data (time domain and frequency domain) in group A 1 year after RFCA; including very low frequency; low frequency (LF); high frequency (HF); R-R interval; root mean squared successive difference interval; the percentage of sinus cycles differing from preceding cycle by more than 50 milliseconds (PNN50); and delta very low frequency, delta LF, delta HF, delta root mean squared successive difference interval and delta PNN50 significantly decreased, compared with that before the procedure. LF/HF, SD of all normal-to-normal intervals, and SD of 5-minute average normal-to-normal intervals were not significantly changed after RFCA. Heart rate variation data in group B 1 year after RFCA was not significantly changed, compared with that before the procedure.


CONCLUSIONS
Radiofrequency catheter ablation operation in site of septal accessory pathway and AV node slow pathway can cause delayed injury of autonomic nerves. Heart rate variation decrement 1 year after RFCA and persistent inappropriate sinus tachycardia post RFCA resulted from delayed injury of cardiac vagus nerve by radiofrequency current.
Guo
Hangyuan
H
Department of Cardiology, Shaoxing People's Hospital, The First Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, China. ghangyuan@hotmail.com <ghangyuan@hotmail.com>
Wang
Ping
P
Xing
Yangbo
Y
Peng
Fang
F
Jiang
Jun
J
Yang
Biao
B
You
Binquan
B
Qiu
Yufang
Y
Lee
Jong-Dae
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology*; D017776:Autonomic Pathways / Q000293:injuries*; D017115:Catheter Ablation / Q000009:adverse effects*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome; D061223:Vagus Nerve Injuries