Changes in heart rate variability parameters following pulsed-field ablation in patients with atrial fibrillation: A systematic review and meta-analysis HRV changes after pulsed-field ablation in AF

Bibliographic Details
Title: Changes in heart rate variability parameters following pulsed-field ablation in patients with atrial fibrillation: A systematic review and meta-analysis HRV changes after pulsed-field ablation in AF
Authors: Xinyi Wang, Zhicheng Hu, Yan Yao, Pakezhati Maimaitijiang, Aiyue Chen, Lihui Zheng
Source: International Journal of Cardiology: Heart & Vasculature, Vol 60, Iss , Pp 101766- (2025)
Publisher Information: Elsevier, 2025.
Publication Year: 2025
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: Atrial fibrillation, Pulmonary vein isolation, Pulsed-field ablation, Heart rate variability, Cardiac autonomic function, Meta-analysis, Diseases of the circulatory (Cardiovascular) system, RC666-701
Description: Introduction: Atrial fibrillation (AF) is a prevalent cardiac arrhythmia. Pulmonary vein isolation (PVI) is a cornerstone for catheter ablation for AF. Most recently, pulsed-field ablation (PFA) has emerged as a novel technique that minimizes tissue damage due to its tissue selectivity with promising clinical success. Despite its promise, the impact of PFA on cardiac autonomic function following PVI, particularly heart rate variability (HRV), and the differences between catheter ablation (CA) techniques, remain unclear. Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis to evaluate changes in HRV parameters in three months post-catheter ablation using PFA, cryoballoon (CRYO), and radiofrequency (RF) ablation techniques. We searched databases including PubMed, Embase, Scopus, and Web of Science for relevant studies, focusing on HRV metrics such as SDNN, LF and HF in AF patients undergoing CA. Results: Our meta-analysis included 35 studies involving 6,267 AF patients. The results demonstrated a significant increase in heart rate and a decrease in HRV parameters such as SDNN and LF following CA in three months. Subgroup analyses revealed variations across ablation techniques, with PFA showing a milder impact on autonomic function compared to CRYO and RF. Notably, PFA was associated with a lower AF recurrence rate, suggesting superior therapeutic efficacy. Conclusion: PFA demonstrates a lower effect on cardiac autonomic function than the other two ablation techniques in three months. Notably, PFA showed a trend toward superior treatment outcomes, which may inform future choices of ablation technique for PVI in AF management. Further research is warranted to explore long-term autonomic effects and optimize treatment protocols.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2352-9067
Relation: http://www.sciencedirect.com/science/article/pii/S2352906725001691; https://doaj.org/toc/2352-9067
DOI: 10.1016/j.ijcha.2025.101766
Access URL: https://doaj.org/article/9e4050be16f84777897952ce43e22fbe
Accession Number: edsdoj.9e4050be16f84777897952ce43e22fbe
Database: Directory of Open Access Journals
Description
ISSN:23529067
DOI:10.1016/j.ijcha.2025.101766