Autonomic effects of radiofrequency catheter ablation

Radiofrequency (RF) catheter ablation has become the treatment of choice fo r a variety of supraventricular tachycardias. Autonomic dysfunction may occ ur during application of RF current; these abnormalities resolve quickly wh en current delivery is terminated. We present a case of sinus node arrest a nd AV block in a 69-year-old woman induced by RF catheter ablation of an AV nodal slow pathway. The proposed mechanisms are a Bezold-Jarisch-like phen omenon or paradoxical activation of cardiac C fibres by direct neural sympa thetic stimulation or RF-induced myocardial injury. Based on a review of pr eviously published reports, autonomic effects of RF ablation are discussed. (Europace 2000; 2: 181-185) (C) 2000 The European Society of Cardiology.