Baroreflex Sensitivity in Patients Undergoing Ablation of Atrial Fibrillation

Poitiers University Hospital116 enrolled

Overview

Atrial fibrillation is the most common arrhythmia. The posterior surface of the left atrium is covered by an extensive network belonging to the autonomic nervous system that can be damaged during the ablation. The involvement of the autonomous nervous system in the genesis and maintenance of atrial fibrillation remains poorly understood. Baroreflex sensitivity is a non-invasive method assessing autonomous nervous system activity. The rate of atrial fibrillation recurrence after ablation is currently high and a better understanding of the mechanisms associated with recurrence is essential to improve selection of the patients who will benefit the most from this procedure. The aim of this study is to evaluate the association between the baroreflex sensitivity and atrial fibrillation recurrences and to analyze the prognostic contribution of the baroreflex measurement compared to other published criteria.

Study Type

OBSERVATIONAL

Enrollment

116

Conditions

Paroxysmal Atrial Fibrillation

Interventions

pulmonary vein isolationPROCEDURE

pulmonary vein isolation : cryoablation or radiofrequency

Eligibility

Sex: ALLMin age: 18 YearsMax age: 99 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥ 18 years old, * Patients with paroxysmal atrial fibrillation, hospitalized for atrial fibrillation ablation, * Assessable baroreflex sensitivity before ablation, * Free subject, without guardianship or curatorship or subordination, * Patients benefiting from a Social Security assurance, * Informed consent signed by the patient after clear and fair information about the study. Exclusion Criteria: * Age \< 18, * History of atrial fibrillation ablation, * Inability to calculate the baroreflex sensitivity * Contraindication to the performance of a cardiac CT scan (allergy to iodine, severe renal insufficiency with clearance \<30 ml/mn/m2), * Inability to have continuous ECG recording by subcutaneous Holter,

Outcomes

Primary Outcomes

Mean slope assessed before ablation in the recurrence and the non-recurrence groups

To compare baroreflex sensitivity assessed by mean Slope 1 month before the ablation in the recurrence group at 1 year and in the no AF recurrence group at 1 year.

Time frame: Recurrence is assessed at one year of follow-up

Secondary Outcomes

Association between baroreflex sensitivity assessed before ablation and atrial fibrillation burden

Association between baroreflex sensitivity evaluated by mean slope, LF gain and HF gain 1 month before AF ablation and AF burden after 1 year of follow-up;

Time frame: Burden is assessed at one year of follow-up

Baroreflex sensitivity fall between the groups with and without AF recurrence

To compare the baroreflex sensitivity fall between before and day1 of ablation between the groups with and without AF recurrence at 1 year follow-up ;

Time frame: Recurrence is assessed at one year of follow-up

Evolution of baroreflex sensitivity

To describe the evolution of baroreflex sensitivity in the group with and in the group without recurrence.

Time frame: Before, day 1 and month 3 after the ablation

Biological and imaging parameters

To look for an association between biological and imaging parameters and atrial fibrillation burden at 1 year.

Time frame: Burden is assessed at one year of follow-up

Quality of life

To compare quality of life before and at one year after atrial fibrillation ablation in patients with and without AF recurrence;

Time frame: before and at one year after atrial fibrillation ablation