A sudden increase in heart rate during ablation of the right superior pulmonary venous vestibule is correlated with pain-relief in patients undergoing atrial fibrillation ablation

BMC Cardiovascular Disorders

Research

ShengXing Tang¹  Ping Fang¹  Xianghai Wang²  Hao Yang²  Youquan Wei²  Jinfeng Wang²  Jichun Liu²  Xiangrong Xie²  Meijun Zhang³ 

[1] Anhui Medical University, 230000, Hefei, Anhui, China;Department of Cardiology, The First Affiliated Hospital (Yijishan Hospital) of Wannan Medical College, 230000, Wuhu, Anhui, China;Department of Cardiology, The First Affiliated Hospital (Yijishan Hospital) of Wannan Medical College, 230000, Wuhu, Anhui, China;Department of Intensive Care Medicine, The First Affiliated Hospital (Yijishan Hospital) of Wannan Medical College, 241001, Wuhu, Anhui, China;

关键词: Atrial fibrillation;    Circumferential pulmonary vein isolation;    Pain;    Ganglionated plexus;    Conscious sedation;   

DOI  :  10.1186/s12872-023-03121-1

 received in 2022-11-18, accepted in 2023-02-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundA sudden increase in heart rate (HR) during ablation of the right superior pulmonary venous vestibule (RSPVV) is often detected in patients undergoing circumferential pulmonary vein isolation (CPVI). In our clinical practices, we observed that some patients had few complaints of pain during the procedures under conscious sedation.AimWe aimed to investigate whether there is a correlation between a sudden increase in HR during AF ablation of the RSPVV and pain relief under conscious sedation.MethodsWe prospectively enrolled 161 consecutive paroxysmal AF patients who underwent the first ablation from July 1, 2018, to November 30, 2021. Patients were assigned to the R group when they had a sudden increase in HR during the ablation of the RSPVV, and the others were assigned to the NR group. Atrial effective refractory period and HR were measured before and after the procedure. Visual Analogue Scale (VAS) scores, vagal response (VR) during ablation, and the amount of fentanyl used were also documented.ResultsEighty-one patients were assigned to the R group, and the remaining 80 were assigned to the NR group. The post-ablation HR (86.3 ± 8.8 vs. 70.0 ± 9.4 b/min; p ≤ 0.001) was higher in the R group than in pre-ablation. Ten patients in the R group had VRs during CPVI, as well as 52 patients in the NR group. The VAS score [2.3 (1.3–3.4) vs. 6.0 (4.4–6.9); p ≤ 0.001)] and the amount of fentanyl used (107 ± 12 vs. 172 ± 26 ug; p ≤ 0.001) were significantly lower in the R group.ConclusionA sudden increase in HR during the ablation of the RSPVV was correlated with pain relief in patients undergoing AF ablation under conscious sedation.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 3