Pulmonary vein isolation (PVI) is the cornerstone in the
treatment of patients with paroxysmal atrial fibrillation (PAF).
Some research has suggested studies have shown that
modification of ganglionated plexuses (GP), performed with PVI,
could lead to even better outcomes. The aim of this study was to
determine the effect of PVI on the autonomic system. Heart rate
variability (HRV) was used as a marker of autonomic system
activity. Twenty-six PAF patients underwent PVI (PVI group) and
twenty patients underwent PVI plus a GP ablation (GP group). In
each group, 5 min long ECG signals obtained before and after the
electrophysiology EP study were analyzed. Time and frequency
domain parameters were evaluated. Vagal responses during
ablation were observed in 15 (58 %) patients in the PVI group
and in 12 (60 %) patients in the GP group. The change in
normalized power in the low frequency (LF) and in the LF/HF
ratio, before and after ablation, was statistically significant in
both groups (LF/HF 2.6±1.6 before vs. 1.4±1.7 after ablation in
PVI group and LF/HF 3.3±2.6 before vs. 1.8±1.9 after ablation in
the GP group). Relative to heart rate variability parameters, there
were no differences between PVI and PVI + plus GP ablation.