[Radiofrequency catheter ablation autonomic nerve injury].

Abstract

OBJECTIVE: To investigate the correlation between RFCA catheter cumulative energy and autonomic nerve injury. METHODS: Forty-one patients with paroxysmal supraventricular tachycardia were enrolled, Patients were excluded if they had Diabetes, Hypertension, Congestive Heart Failure or other organic heart disease. HRV and biochemical markers were measured before and after the RFCA. RESULTS: Compared with pre-ablation values,there was significantly decrease in post-ablation low frequency (LF) and high frequency (HF). This was noted in both the septal group (AVNRT and septal pathway) and free wall group (free wall accessory pathway).Post-procedure,the sensitivity of cardiac troponin I(cTnI) for myocardial injury detection was 58.3%, AST was 41.7%. This was significantly higher than other markers(CK:4.2%, CK-MB:10.4%, LDH:20.8%). The post-ablation sensitivity of cTnI was 54.2%, 6.3% and 52.1%at 1 hour, 12 hours, and 24 hours respectively. A significant correlation between cumulative energy and delta HF(r=0.688,P=0.01) or delta LF (r=0.462, P<0.05).was noted in free wall group.(delta HF=pre-ablation HF-post-ablation HF/pre-ablation HF x 100%). There was no significant correlation between biochemical markers and either delta HF or delta LF. CONCLUSION: RFCA induced injury on cardiac autonomic nerves related to both cumulative energy and ablation site,but not size of myocardial injury as determined by cTnI measurement. cTnI is an excellent biochemical marker of myocardial injury.

AI evidence extraction

Main findings

Post-ablation LF and HF were significantly decreased compared with pre-ablation values in both septal and free wall groups. In the free wall group, cumulative ablation energy correlated with delta HF (r=0.688, P=0.01) and delta LF (r=0.462, P<0.05). No significant correlation was found between biochemical markers and delta HF or delta LF; cTnI showed higher sensitivity for myocardial injury detection than other markers.

Outcomes measured

• Heart rate variability (HRV): low frequency (LF), high frequency (HF)
• Biochemical markers of myocardial injury: cardiac troponin I (cTnI), AST, CK, CK-MB, LDH
• Correlation of cumulative ablation energy with changes in HRV (delta HF, delta LF)

Limitations

• Frequency and specific RF exposure parameters (e.g., MHz, SAR) not reported
• Study design not specified in abstract (e.g., randomized vs observational)
• Short-term pre/post assessment only; longer-term autonomic outcomes not described
• Correlation with cumulative energy reported only for the free wall group

Suggested hubs

• medical-rf-ablation (0.9)
  Study evaluates physiologic injury related to radiofrequency catheter ablation energy and site.

{
    "study_type": "other",
    "exposure": {
        "band": null,
        "source": "radiofrequency catheter ablation (RFCA)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Patients with paroxysmal supraventricular tachycardia (excluded if diabetes, hypertension, congestive heart failure, or other organic heart disease)",
    "sample_size": 41,
    "outcomes": [
        "Heart rate variability (HRV): low frequency (LF), high frequency (HF)",
        "Biochemical markers of myocardial injury: cardiac troponin I (cTnI), AST, CK, CK-MB, LDH",
        "Correlation of cumulative ablation energy with changes in HRV (delta HF, delta LF)"
    ],
    "main_findings": "Post-ablation LF and HF were significantly decreased compared with pre-ablation values in both septal and free wall groups. In the free wall group, cumulative ablation energy correlated with delta HF (r=0.688, P=0.01) and delta LF (r=0.462, P<0.05). No significant correlation was found between biochemical markers and delta HF or delta LF; cTnI showed higher sensitivity for myocardial injury detection than other markers.",
    "effect_direction": "harm",
    "limitations": [
        "Frequency and specific RF exposure parameters (e.g., MHz, SAR) not reported",
        "Study design not specified in abstract (e.g., randomized vs observational)",
        "Short-term pre/post assessment only; longer-term autonomic outcomes not described",
        "Correlation with cumulative energy reported only for the free wall group"
    ],
    "evidence_strength": "low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency catheter ablation",
        "autonomic nerve injury",
        "heart rate variability",
        "LF",
        "HF",
        "cumulative energy",
        "cardiac troponin I",
        "supraventricular tachycardia"
    ],
    "suggested_hubs": [
        {
            "slug": "medical-rf-ablation",
            "weight": 0.90000000000000002220446049250313080847263336181640625,
            "reason": "Study evaluates physiologic injury related to radiofrequency catheter ablation energy and site."
        }
    ]
}

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