PO-04-064 QUANTIFICATION OF AUTONOMIC MODULATION DURING SINGLE-SHOT PULMONARY VEIN ISOLATION WITH PULSED FIELD ABLATION

Additional ganglionated plexi (GPs) ablation beyond pulmonary vein isolation (PVI) has been associated with better outcomes after radiofrequency ablation. Because of the anatomical relationship between major atrial GPs and veins, single-shot PVI cryoballoon catheter (CBA) demonstrated to concomitantly affect GPs, as documented by intraprocedural vagal reactions increased heart rates (HR) The novel multispline pulsed field (PFA) is emerging a safe effective non-thermal alternative for PVI, selectivity cardiac tissue. To quantify degree parasympathetic denervation during PFA compared CBA. We prospectively included consecutive patients undergoing autonomic modulation assessment extracardiac stimulation (ECVS) paroxysmal AF Patients previous ablations were excluded. response ECVS was determined sinus pause following stimulation, measuring maximum PP interval (sinus node response). Baseline post-ablation responses collected analysed. in two groups assessed evaluating difference pre- ECVS. A total 30 (PFA group, n=15 vs CBA n=15) analysis. patients’ characteristics similar (Table 1). Pre-ablation (10757.3 ± 3155.2 ms vs. 11155.9 2472.3 ms, p=0.70). Vagal occurred more frequently than (86.7% 20%, p=0.001), commonly left superior PVI. After significantly longer (9897.9 2702.0 874.6 213.6 ms; p<0.001, Figure Despite baseline values, 24h HR (14.0 6.8 bpm 1.8 8.4 bpm, respectively; p<0.001). Single-shot less at testing. This likely result tissue selectivity, minimal effect on nervous system. clinical impact reduced outcome yet be elucidated.