Objective To evaluate the therapeutic effects of circumferential pulmonary vein ablation (CPVA) on the autonomic nerve function and prognosis of patients with paroxysmal atrial fibrillation (PAF). Methods A total of 110 consecutive patients with symptomatic and drug refractory PAF [age of (59.07±11.54) years, 67 males and 43 females] undergoing CPVA in our department from January to December 2011 were enrolled in this study. They all received pulmonary vein isolation (PVI) during CPVA. The time-domain analyses of heart rate variability (HRV) were obtained by 24-hour Holter monitoring before and at 2 days after ablation, and the efficacy of CPVA was evaluated and analyzed according to the changes of HRV. Results After the follow-up of (14.46±5.57) months, the success rate for atrial fibrillation (AF) was 72.45% for 98 patients who finished the study. According to the outcome, these patients were divided into 2 groups, success group (n＝71, 45 males and 26 females) and recurrence group (n＝27, 15 males and 12 females). Before ablation, there was no difference in HRV indices between the success group and recurrence group. After ablation, HRV indices were decreased significantly in both groups (P＜0.05), with those in success group dramatically lower than those in recurrence group (P＜0.05). Conclusions CPVA significantly reduces HRV and induces autonomic dysfunction, which may be one of the underlying mechanisms of its treatment for PAF. Enhancing denervation has effects on the long-term success of PAF ablation. These results identify the relationship between AF ablation and HRV.