I Impact of Atrial Fibrillation on the Vagal Response to Ganglionated Plexi Stimulation: Comparison Between Patients with and without Atrial Fibrillation

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  • Takahashi Keiko
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Watanabe Ichiro
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Okumura Yasuo
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Nagashima Koichi
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Wakamatsu Yuji
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Arai Masaru
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Watanabe Ryuta
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Kurokawa Sayaka
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Okubo Kimie
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Nakai Toshiko
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Hirayama Atsushi
    Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
  • Iso Kazuki
    Division of Cardiology, Department of Medicine, Kawaguchi City Hospital, Kawaguchi-city, Saitama Prefecture, Japan
  • Kunimo Satoshi
    Division of Cardiology, Department of Medicine, Kawaguchi City Hospital, Kawaguchi-city, Saitama Prefecture, Japan
  • Sonoda Kazumasa
    Division of Cardiology, Department of Medicine, Tokyo Rinkai Hospital, Edogawa-ku, Tokyo, Japan
  • Tosaka Toshimasa
    Division of Cardiology, Department of Medicine, Tokyo Rinkai Hospital, Edogawa-ku, Tokyo, Japan

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Background: Pacing induced atrial fibrillation (AF) has been shown to induce significant increases in sympathetic and parasympathetic neurons in dogs, and the efficacy of cardiac autonomic denervation by ganglionated plexi (GP) has been shown to increase the freedom from recurrence of AF. We compared the GP response to high-frequency stimulation (HFS) in patients with and without AF. Methods: The responses to HFS (20 Hz, 25 mA, 10 ms) at 5 left atrial GP sites were evaluated in 24 patients with AF (paroxysmal: 11, persistent AF: 5) and 16 patients with left side accessory pathways . Results: Vagal responses (> 50% increase in RR interval) to HFS were more frequently observed in patients with AF (Table). Conclusions: AF increases left atrial cardiac autonomic nervous system activity, which may contribute to the adjunct role of GP ablation following pulmonary vein isolation

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