ArticleJournal of arrhythmia2025
Pulmonary vein isolation does not alter cardiovascular afferent autonomic reflexes in atrial fibrillation.
Article in Journal of arrhythmia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Detailed Association Between Pulmonary Vein Isolation and Cardiovascular Reflex.Journal of arrhythmia · 2025Article
- Critical Concerns Regarding the Conclusions of Pulmonary Vein Isolation's Impact on Cardiovascular Autonomic Reflexes.Journal of arrhythmia · 2025Article
- Pulmonary vein isolation does not alter cardiovascular afferent autonomic reflexes in atrial fibrillation.Journal of arrhythmia · 2025Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Pulmonary vein isolation (PVI) remains the cornerstone of atrial fibrillation (AF) ablation. We previously demonstrated abnormal cardiac volume-sensitive reflexes (whose receptors are co-located in veno-atrial tissue) in AF patients. Whether PVI disrupts afferent nerves is unknown. Objectives: Evaluate whether PVI disrupts afferent volume-sensitive reflexes. Methods: We consecutively studied autonomic reflexes in AF patients undergoing PVI, repeating the study post-PVI, if AF-free >6 months. We excluded patients with AF recurrence/procedural complications, allowing repeat procedures. We measured beat-to-beat mean arterial pressure (MAP) and heart rate (HR) continuously during low-level Lower Body Negative Pressure (LBNP), at 0, -20 and -40 mmHg (predominantly testing volume baroreceptors); Valsalva reflex (predominantly arterial baroreceptors); and Isometric Handgrip reflex (IHR, both). LBNP produces reflex vasoconstriction, evaluated from forearm blood flow (FBF ∝ 1/vascular resistance). Results: 18 patients were studied pre-PVI; Conclusion: PVI does not impair cardiovascular reflexes involving afferent baroreceptors, suggesting HRV changes reflect efferent modulation or ablation adequacy rather than afferent disruption. Whether disrupting sino-atrial efferent nerves represents a marker of adequate ablation or influences PVI outcomes requires evaluation.
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