Related Experiment Video
Updated: Jun 25, 2026

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
Vagal modification can also help prevent late recurrence of atrial fibrillation after segmental pulmonary vein
Naoki Yoshida1, Takumi Yamada, Yoshimasa Murakami
1Department of Cardiology, Nagoya University Graduate School of Medicine, and Division of Cardiology, Nagoya Dai-ni Red Cross Hospital, Cardivascular Center, Nagoya, Japan.
Background:
The relationship between vagal modification and paroxysmal atrial fibrillation (PAF) recurrence after segmental pulmonary vein (PV) isolation (S-PVI) was investigated.
Methods And Results:
S-PVI was performed in 77 PAF patients using a multielectrode basket or circular catheter to achieve electrical disconnection of all 4 PVs independent of eliminating vagal reflexes. Serial Holter-recordings were obtained at baseline, immediately and 1, 3, 6, and 12 months after S-PVI to analyze the heart rate variability. Fifty-one patients were free from symptomatic PAF (Group A) and 26 had late PAF recurrences (Group B) at 12-month follow-up. Immediately after S-PVI, the root mean square of the successive differences (rMSSD) and high-frequency (HF) power, which reflected parasympathetic nervous activity, were significantly lower in Group A than in Group B (rMSSD: 33.6+/-26.0 vs 60.6+/-23.2 ms, P<0.05; ln HF: 8.73+/-0.84 vs 9.31+/-0.95 ms2, P<0.05). There were no significant differences in the average heart rate or ratio of the low-frequency to HF powers between the 2 groups. By multivariate analysis, only the HF immediately after S-PVI was an independent predictor of PAF recurrence (hazard ratio 1.707, 95% confidence interval 1.057-2.756, P<0.05).
Conclusions:
Vagal modification after S-PVI could also help prevent late recurrence of PAF.
Related Concept Videos
Mitral Regurgitation III: Medical Management
Dysrhythmias VI: Management of Dysrhythmias
Mitral Stenosis III: Medical Management
Varicose Veins II: Diagnostic Studies and Interprofessional Care
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

