Effects of low-dose metoprolol succinate sustained-release tablets on patients with paroxysmal atrial fibrillation undergoing circumferential pulmonaryvein isolation:a retrospective study

Objective The atria, particularly those near the pulmonary vein ostium,have numerous autonomic neural plexuses. Circumferential pulmonary vein isolation (CPVI) can reduce heart rate variability (HRV) parameters. Studies have suggested that continuing antiarrhythmic drugs (AAD) for 1-year post-CPVI can reduce the recurrence of atrial arrhythmias within the year. However, the arrhythmogenic risk associated with AADs is notable. Currently, there is a shortage of adequate studies on the effectiveness and safety of using AADs following CPVI. This study evaluated the impact of low-dose sustained-release metoprolol succinate on Holter in individuals with paroxysmal atrial fibrillation (PAF) after CPVI. Methods P with PAF who underwent initialCPVI at Shaoxing People’s Hospital between September 2022 and January 2024 were included. Patients underwent 24-h Holter monitoring before surgery and at 1 − 3, 6, 12, and 18 months after surgery. The participantswere separated into medication and non-medication groups according to their heart rate, blood pressure, and clinical experience. Results A total of 67 patients completed the 24-h Holter monitoring, with 33 receiving low-dose metoprolol succinate (medication group) and 34 not receiving AAD (non-medication group). No significant differences were observed in HRV parameters and arrhythmia data between the two groups or across the different time points. Conclusion Oral low-dose sustained-release metoprolol succinate tablets had no significant short-term effects on HRV parameters or arrhythmia data in patients with PAF post-CPVI. CPVI can cause autonomic dysfunction, and HRV parameters were gradually restored to normal 3-months post-surgery.