Changes in Heart Rate Variability Parameters Following Radiofrequency Ablation in Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis

Cardiovasc Drugs Ther. 2025 Aug;39(4):887-901. doi: 10.1007/s10557-024-07549-1. Epub 2024 Jan 30.

Abstract

Purpose: Radiofrequency (RF) ablation is a prevalent treatment for atrial fibrillation (AF), targeting triggers within the pulmonary vein (PV) for elimination. This study evaluated heart rate variability (HRV) parameter changes at three intervals post-RF ablation: short-term (immediately to 1 month), medium-term (1 to 6 months), and long-term (6 months to 1 year). We compared two ablation techniques: circumferential PV isolation (CPVI) and segmental PV isolation (SPVI).

Methods: A thorough search of databases, including PubMed, Embase, Scopus, Web of Science, and Cochrane, in 2022 yielded 835 pertinent studies. After inclusion criteria were applied, 22 studies were analyzed.

Results: Results showed a marked decline in HRV parameters post-AF ablation, with LF/HF as an exception. These reductions persisted in short- and long-term evaluations up to a year post-procedure. Subgroup analysis revealed significant HRV declines, with distinct LF/HF values post-SPVI.

Conclusion: This meta-analysis suggests the potential of decreased HRV as an indicator of autonomic denervation, necessitating further exploration to optimize therapeutic strategies and enhance patient outcomes.

Keywords: Atrial fibrillation; Catheter ablation; Heart rate variability; Pulmonary vein isolation.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Aged
  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / physiopathology
  • Atrial Fibrillation* / surgery
  • Catheter Ablation* / adverse effects
  • Female
  • Heart Rate*
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Veins* / innervation
  • Pulmonary Veins* / physiopathology
  • Pulmonary Veins* / surgery
  • Time Factors
  • Treatment Outcome