Relationships Between P Wave Dispersion, Heart Rate Variability And Recurrence After Radiofrequency Ablation For Paroxysmal Atrial Fibrillation

Background：Atrial fibrillation (atrial fibrillation, AF) is one of the most commonarrhythmias. The mechanism of atrial fibrillation mainly includes theory of focal originsand reentry, It is very important for cardiovascular doctor fully understand the occurrenceand maintenance mechanisms of AF.Atrial circumferential pulmonary vein isolation canblock the relationship between atrium and pulmonary veins, but sometimes recurrencecould occur.Reducing the recurrence rate of AF after radiofrequency ablation is thecommon focus. Some scholars believe that P wave dispersion is a sensitive and specificpredictive indicators of the AF occurrence. Cardiac autonomic nervous activity plays animportant role in the incidence of atrial fibrillation, and heart rate variability can be used toassess autonomic nervous activity.Objective: To observed the maximum width of the P wave (Pmax), P wave dispersion (Pd)and heart rate variability (HRV) in paroxysmal atrial fibrillation (PAF) patients before andafter circumferential pulmonary vein ablation,exploring the Pd and HRV to predict thevalue of recurrence of PAF.Methods: According to the inclusion and exclusion criteria,we recruited56paroxysmalatrial fibrillation patients underwent circumferential pulmonary vein ablation.Collectingrelevant clinical datas, such as ECG,and holter, and the maximum duration ofPwave(Pmax),P wave dispersion(Pd), and heart rate variability are measured The patientsare followed up for9months.According to the3months follow-up results, the patientswere divided into early recurrence group and early non-recurrence group, according to thethe3-9months follow-up results，the patients were divided into late recurrence group andcured group.Results:.Follow-up results showed that there are15patients with early relapse, including 12cases of PAF, and the early arrhythmia recurrence rate was26.78%; there are10patients with late recurrence, including9cases of atrial fibrillation and1case of atrialflutter, and the late recurrence rate was16.07%;46patients were cured and the surgicalsuccess rate was82.14%. After the radiofrequency ablation, the Pmax was lower in earlynon-recurrence group than early recurrence group (P <0.05); Pmax and Pd were lower incured group than the late recurrence group (P <0.05); mean heart rate(mHR) and heart ratevariability (HRV) were lower while LF/HF was higher in early non-recurrence groupthan early recurrence group(P <0.05); rMSSD and HF (on behalf of the vagus) in curedgroup were lower than the late recurrence group,and LF/HF (on behalf of the balance ofsympathetic and vagus) increased in cured group.Conclusion:1.Pmax is a predictive factor of early and late recurrence of AF afterradiofrequency ablation and Pd has a predictive value for late recurrence of AF;2.Damageof vagus nerve can increase the efficacy of atrial fibrillation ablation, and low vagalactivity may reduce PAF recurrence after circumferential pulmonary vein ablation...