Baroreflex activity change after pulmonary vein isolation in patients with atrial fibrillation

Abstract

Aim. To study the intraprocedural changes in baroreflex activity after catheter pulmonary vein isolation in paroxysmal atrial fibrillation patients.Methods. From October 2021 to June 2022, sinus rhythm was registered at the start of procedure in 21 patients with paroxysmal atrial fibrillation admitted for catheter pulmonary vein isolation. Patients before and after procedure were tested with phenylephrine. Pre- and postoperative baroreflex activity and sinus rhythm rate were analyzed.Results. After catheter pulmonary vein isolation, the baroreflex activity decreased from 5.8 [3.5; 11.3] ms/mmHg to 0.3 [-0.1; 1.8] ms/mmHg, р<0.001, based on systolic arterial pressure, and from 9.5 [5.1; 15.5] ms/mmHg to 0.6 [0; 7.6] ms/mmHg, p=0.033, based on diastolic arterial pressure.Conclusion. Intraprocedural phenylephrine test allows to study the baroreflex activity changes and to assess the modification of cardiac autonomic innervation.