{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:18:53Z","timestamp":1771510733639,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Thermal atrial fibrillation (AF) ablation exerts an additive treatment effect on the cardiac autonomic nervous system (CANS). This effect is mainly reported during ablation of the right superior pulmonary vein (RSPV), modulating the right anterior ganglionated plexus (RAGP), which contains parasympathetic innervation to the sinoatrial node in the epicardial fat pad between RSPV and superior vena cava (SVC). However, a variable response to neuromodulation after ablation is observed, with little to no effect in some patients. Our objective was to assess clinical and anatomic predictors of thermal ablation\u2010induced CANS changes, as assessed via variations in heart rate (HR) postablation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive paroxysmal AF patients undergoing first\u2010time PV isolation by the cryoballoon (CB) or radiofrequency balloon (RFB) within a 12\u2010month time frame and with preprocedural cardiac computed tomography (CT), were evaluated. Preablation and 24\u2010h postablation electrocardiograms in sinus rhythm were collected and analyzed to assess HR. Anatomic evaluation by CT included the measurement of the shortest distance between the SVC and RSPV ostium (RSPV\u2010SVC distance).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 97 patients (CB, <jats:italic>n<\/jats:italic>\u2009=\u200950 vs. RFB, <jats:italic>n<\/jats:italic>\u2009=\u200947) were included, with similar baseline characteristics between both groups. A significant HR increase postablation (\u0394HR\u2009\u2265\u200915\u2009bpm) occurred in a total of 37 patients (38.1%), without difference in number of patients between both thermal ablation technologies (CB, 19 [51%]), RFB, 18 [49%]). Independent predictors for increased HR were RSPV\u2010SVC distance (odds ratio [OR]: 0.49, CI: 0.34\u20130.71, <jats:italic>p<\/jats:italic> value\u2009&lt;\u2009.001), and age (OR: 0.94, CI: 0.89\u20130.98, <jats:italic>p<\/jats:italic> value\u2009=\u2009.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thermal balloon\u2010based PV isolation influences the CANS through its effect on the RAGP, especially in younger patients and patients with shorter RSPV\u2010SVC distance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16401","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T05:44:48Z","timestamp":1723527888000},"page":"1997-2005","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Distance\u2010dependent neuromodulation effect during thermal ablation for atrial fibrillation"],"prefix":"10.1111","volume":"35","author":[{"given":"Kazutaka","family":"Nakasone","sequence":"first","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing Universitair Ziekenhuis Brussel\u2014Vrije Universiteit Brussel Brussels Belgium"},{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaoru","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Radiology Universitair Ziekenhuis Brussel\u2014Vrije Universiteit Brussel Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvise","family":"Del Monte","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing Universitair Ziekenhuis Brussel\u2014Vrije Universiteit Brussel Brussels 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