Influence of radiofrequency catheter ablation on myocardial metabolism

We investigated the change of the arterial-coronary sinus lactate difference before and after radiofrequency ablation to assess the influence of radiofrequency ablation on myocardial metabolism. Sixteen patients underwent radiofrequency catheter ablation and blood sampling. The patients were further divided into two groups according to the energy received, group 1 (n = 8) with lower energy and group 2 (n = 8) with higher energy. The postpacing arterial-coronary sinus lactate difference was significantly higher than that 1 min after ablation (0.18 +/- 0.16 vs. -0.08 +/- 0.14 mmol/l, P < 0.01). The mean arterial-coronary sinus lactate difference obtained at 3 min, 5 min and 10 min increased gradually and finally approximated the postpacing lactate difference. The arterial-coronary sinus lactate difference 1 min after ablation of group 2 was significantly lower than that of group 1 (-0.03 +/- 0.14 vs. -0.13 +/- 0.14 mmol/l, P < 0.01). The arterial coronary sinus lactate differences of group 2 obtained at 3 min, 5 min and 10 min were also lower than those of group 1. However, the difference between the two groups decreased with time. This finding suggests that radiofrequency energy has an influence on the myocardial metabolism and higher energy causes more metabolic alteration than lower energy.