The goal of this study is to compare effectiveness of cardioneuroablation of right anterior ganglionated plexus and pulmonary vein isolation in patients with enhanced vagal tone expressed as deceleration capacity \>7.5ms.
Paroxysmal atrial fibrillation documented in ECG or Holter monitoring
Deceleration capacity >7.5ms
Life expectancy more than 1 year
Age ≥18 years
Permanent AF lasting more than one year or persistent AF lasting more than 7 days
AF secondary to electrolyte imbalance, thyroid disease, alcohol abuse, or other non-heart related causes
Anteroposterior dimension of the left atrium in the echocardiography ≥43mm
Clinically significant arrhythmias other than AF
Parallel
Cardioneuroablation of right anterior ganglionated plexus
Procedure/SurgeryRight anterior ganglionated plexus will be localized using anatomical approach. Radiofrequency energy will be delivered until heart rate acceleration \>30% is achieved or if radiofrequency time exceeds 120 seconds.
Pulmonary vein isolation
Procedure/SurgeryApplication sites near the ostia of pulmonary veins will be determined. Radiofrequency energy will be delivered using point-by-point technique. After applications, the acute PVI endpoint will be confirmed by the elimination of PV potentials and lack of capture during pacing from the ablation lines.
AF recurrence
AF episode lasting 30 seconds or more, documented on 12-lead ECG, event or Holter monitoring
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