Sympathetic stimulation affects atrial vulnerability in paroxysmal supraventricular tachycardia patients with atrial fibrillation

摘要

Atrial fibrillation (AF) occurs more frequently in paroxysmal supra-ventricular tachycardia (PSVT) patients compared with the general population. Even after successful treatment of the arrhythmia, the AF recurrence rate for the PSVT patients is still high (6-10% for atrioven-tricular reentrant tachycardia, AVRT and 28% for atrioventricular nodal reentrant tachycardia, AVNRT patients) [1,2]. Consequently, the accessory pathways (AP) and the slow pathway of the atrioventricular node may not be the only factors that influence atrial vulnerability, which was defined as the occurrence of spontaneous and inducible AF and maintenance and perpetuation of the arrhythmia in atrial tissues according to the electrophysiological mechanisms underlying AF [3,4], in PSVT patients. Programmed atrial stimulation with and without isoprenaline infusion, which can induce AF on occasion, is widely used to evaluate the effectiveness of the radiofrequency catheter ablation (RFCA) in PSVT patients [5].