{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T08:48:02Z","timestamp":1771490882476,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T00:00:00Z","timestamp":1727481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDB\/00306\/2020"],"award-info":[{"award-number":["UIDB\/00306\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Catheter ablation (CA) is a well-established treatment for atrial fibrillation (AF). However, its effects on autonomic function and underlying mechanisms remain poorly understood. This study investigated autonomic and haemodynamic changes following CA and explored their potential implications for patient outcomes. Methods: Seventy-eight patients with AF underwent CA and were followed up at one, three, and six months. Autonomic function was assessed using a combination of head-up tilt (HUT), handgrip (HG), and deep breathing (DB) manoeuvres along with baroreflex sensitivity (BRS) and baroreflex effectiveness index (BEI) evaluation. Heart rate (HR), blood pressure (BP), and their variability were measured at each time point. Results: Significant autonomic alterations were observed after ablation, particularly at one month, with reductions in parasympathetic tone and baroreflex function. These changes gradually normalised by six months. Both pulmonary vein isolation (PVI) and cryoablation (CryO) had similar effects on autonomic regulation. Improvements in quality of life, measured by the AFEQT scores, were consistent with these physiological changes. Conclusions: CA for AF induces significant time-dependent autonomic and haemodynamic changes with recovery over six months. These findings underscore the need for ongoing monitoring and personalised post-ablation management. Further research is required to explore the mechanisms driving these alterations and their long-term impacts on patient outcomes.<\/jats:p>","DOI":"10.3390\/jcm13195796","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T06:39:35Z","timestamp":1727678375000},"page":"5796","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["AFTER-CA: Autonomic Function Transformation and Evaluation Following Catheter Ablation in Atrial Fibrillation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7066-7770","authenticated-orcid":false,"given":"Monica","family":"Ferreira","sequence":"first","affiliation":[{"name":"Faculdade de Medicina and Centro Cardiovascular da Universidade de Lisboa-CCUL, Universidade de Lisboa, 1649-004 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9465-634X","authenticated-orcid":false,"given":"Pedro Silva","family":"Cunha","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de Santa Marta, Unidade Local de Sa\u00fade de S. Jos\u00e9, 1150-199 Lisbon, Portugal"},{"name":"Pediatric Cardiology Department, Hospital de Santa Marta, Unidade Local de Sa\u00fade de S. Jos\u00e9, 1150-199 Lisbon, Portugal"}]},{"given":"Ana Clara","family":"Felix","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Department, Hospital de Santa Marta, Unidade Local de Sa\u00fade de S. Jos\u00e9, 1150-199 Lisbon, Portugal"}]},{"given":"Helena","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de Santa Marta, Unidade Local de Sa\u00fade de S. Jos\u00e9, 1150-199 Lisbon, Portugal"},{"name":"Pediatric Cardiology Department, Hospital de Santa Marta, Unidade Local de Sa\u00fade de S. Jos\u00e9, 1150-199 Lisbon, Portugal"}]},{"given":"Mario","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina and Centro Cardiovascular da Universidade de Lisboa-CCUL, Universidade de Lisboa, 1649-004 Lisbon, Portugal"},{"name":"Cardiology Department, Hospital de Santa Marta, Unidade Local de Sa\u00fade de S. Jos\u00e9, 1150-199 Lisbon, Portugal"},{"name":"Pediatric Cardiology Department, Hospital de Santa Marta, Unidade Local de Sa\u00fade de S. Jos\u00e9, 1150-199 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2169-4024","authenticated-orcid":false,"given":"Sergio","family":"Laranjo","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Department, Hospital de Santa Marta, Unidade Local de Sa\u00fade de S. Jos\u00e9, 1150-199 Lisbon, Portugal"},{"name":"CHRC, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal"}]},{"given":"Isabel","family":"Rocha","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina and Centro Cardiovascular da Universidade de Lisboa-CCUL, Universidade de Lisboa, 1649-004 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/S1474-4422(07)70264-8","article-title":"Atrial fibrillation and stroke prevention","volume":"6","author":"Lip","year":"2007","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1093\/europace\/euac144","article-title":"Searching for atrial fibrillation: Looking harder, looking longer, and in increasingly sophisticated ways. 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