{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:10:20Z","timestamp":1792642220699,"version":"4.5.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2006,8,29]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    The aim of this study was to evaluate whether selective radiofrequency (RF) catheter ablation of the atrial sites in which high-frequency stimulation induces vagal reflexes prevents paroxysmal atrial fibrillation (AF).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Ten patients with episodes suggestive of vagal-induced paroxysmal AF and no heart disease were selected for percutaneous epicardial and endocardial mapping of the atria to search for sites in which high-frequency transcatheter stimulation (20 Hz,) induced vagal reflexes. A vagal response defined as AV block of &gt;2 seconds was elicited in 7 of 10 patients (70%) with an average of 5\u00b12.4 (range, 2 to 9) sites per patient, and RF pulses (21.0\u00b112.0 per patient) were applied at those sites to eliminate all evoked vagal reflexes. The 3 patients in whom evoked vagal reflexes were not obtained underwent circumferential pulmonary vein ablation with an average of 58.0\u00b113.9 RF pulses per patient (\n                    <jats:italic>P<\/jats:italic>\n                    =0.022). Autonomic evaluation was performed before and 48 hours and 3 months after the procedure and was consistent with vagal withdrawal in all patients. Two of the 7 patients who underwent denervation remained asymptomatic without the use of antiarrhythmic medication at a mean follow-up of 8.3\u00b12.8 months (range, 5 to 15 months); 4 had frequent recurrences and were referred for circumferential pulmonary vein ablation; and 1 had few AF episodes without antiarrhythmic medication. The 3 patients without evoked vagal reflexes who underwent circumferential pulmonary vein ablation remained asymptomatic without antiarrhythmic medication. One patient had acute delayed gastric emptying after atrial vagal denervation.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    RF catheter ablation of selected atrial sites in which high-frequency stimulation induced vagal reflexes may prevent AF recurrences in selected patients with apparently vagal-induced paroxysmal AF.\n                  <\/jats:p>","DOI":"10.1161\/circulationaha.106.633560","type":"journal-article","created":{"date-parts":[[2006,8,21]],"date-time":"2006-08-21T20:13:41Z","timestamp":1156191221000},"page":"876-885","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":229,"title":["Selective Atrial Vagal Denervation Guided by Evoked Vagal Reflex to Treat Patients With Paroxysmal Atrial Fibrillation"],"prefix":"10.1161","volume":"114","author":[{"given":"Mauricio","family":"Scanavacca","sequence":"first","affiliation":[{"name":"From the Heart Institute, University of Sa\u0303o Paulo Medical School, Sa\u0303o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano F.","family":"Pisani","sequence":"additional","affiliation":[{"name":"From the Heart Institute, University of Sa\u0303o Paulo Medical School, Sa\u0303o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Hachul","sequence":"additional","affiliation":[{"name":"From the Heart Institute, University of Sa\u0303o Paulo Medical School, Sa\u0303o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sissy","family":"Lara","sequence":"additional","affiliation":[{"name":"From the Heart Institute, University of Sa\u0303o Paulo Medical School, Sa\u0303o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Hardy","sequence":"additional","affiliation":[{"name":"From the Heart Institute, University of Sa\u0303o Paulo Medical School, Sa\u0303o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Darrieux","sequence":"additional","affiliation":[{"name":"From the Heart Institute, University of Sa\u0303o Paulo Medical School, Sa\u0303o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivani","family":"Trombetta","sequence":"additional","affiliation":[{"name":"From the Heart Institute, University of Sa\u0303o Paulo Medical School, Sa\u0303o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Eduardo","family":"Negra\u0303o","sequence":"additional","affiliation":[{"name":"From the Heart Institute, University of Sa\u0303o Paulo Medical School, Sa\u0303o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Sosa","sequence":"additional","affiliation":[{"name":"From the Heart Institute, University of Sa\u0303o Paulo Medical School, Sa\u0303o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)01107-4"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021328"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199809033391003"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.102.21.2619"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.104.478263"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000095796.45180.88"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000112641.16340.C7"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.01.027"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.06.026"},{"key":"e_1_3_2_10_2","first-page":"645","volume":"71","year":"1978","unstructured":"Coumel P, Attuel P, Lavallee J, Flammang D, Leclercq JF, Slama R. 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