Evaluation of the effect of radiofrequency catheter ablation on autonomic function in patients with atrioventricular nodal reentrant tachycardia by head-up tilt table test


Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran


Background: One of the recommended treatments for atrioventricular nodal reentrant tachycardia (AVNRT), 
is radiofrequency catheter ablation (RFCA). However, RFCA may affect the autonomic system. This 
study aims to evaluate the effect of RFCA on autonomic system in patients with PSVT by head‑up tilt 
table (HUTT) test.
Materials and Methods: In a before–after study, 22 patients with PSVT were enrolled. Data were collected 
with a data collection form that included two parts. Electrocardiogram (ECG), echocardiogram, 24‑h Holter 
monitoring, HUTT test, heart rate variability (HRV) indexes, and symptoms of all patients were recorded 
24 h before and 1 month after the ablation. Wilcoxon, McNemar, Mann–Whitney U, and Chi‑square tests 
were used to analyze the data. 
Results: Of the total 22 patients, 31.8% were male and 68.2% were female. There were significant differences 
in heart palpitation (P < 0.0001) and non‑specific symptoms (P = 0.031) and no significant difference in 
head‑up tilt test results and HRV indices before and after RFCA. The results showed that there were no 
significant differences in specific and non‑specific symptoms in patients with AVNRT with positive and 
negative HUTT before and after RFCA.
Conclusions: The observed difference in heart palpitation and non‑specific symptoms emphasized the role 
of AVNRT in causing these symptoms. Autonomic dysfunction is more probably an accompanying condition 
of AVNRT than causing symptoms. We could not find any significance in the results of HUTT after RFCA. 
HUTT cannot determine or predict the symptoms after RFCA.


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