OBJECTIVES: This study was designed to assess the temporal changes in vagal responses to atrial premature beats before spontaneous onset of atrial fibrillation (AF). BACKGROUND: Enhanced vagal activity plays a major role in the onset and perpetuation of experimental AF, but the role of vagal activation in the onset of clinical AF episodes is not so well established. METHODS: We calculated heart rate turbulence after atrial premature impulses occurring 0 to 60 min before the onset of AF ("prior to AF") and compared it with the hourly means of the other hours of the 24-h electrocardiogram recordings ("non-AF hours") in 39 patients with structural heart disease and 29 patients with lone AF. Traditional heart rate variability measurements and approximate entropy (ApEn) were also analyzed. RESULTS: Turbulence onset (TO) was significantly less negative during the 1 h preceding AF than during the non-AF hours (0.71 +/- 1.76 vs. -0.35 +/- 1.46, p < 0.00001). Less negative TO before AF was observed among both the patients with structural heart disease (1.16 +/- 1.73 vs. 0.07 +/- 1.23; p < 0.0001) and those with lone AF (0.17 +/- 1.67 vs. -0.85 +/- 1.56; p < 0.0001). No significant difference was seen in the turbulence slope between the two periods, and none of the traditional frequency and time domain measurements differentiated between the periods; ApEn was significantly lower before AF than during the non-AF hours (p < 0.01). CONCLUSIONS: Altered heart rate dynamics, suggesting transient enhancement of vagal outflow after premature atrial excitation, are temporally related to spontaneous onset of clinical AF.
OBJECTIVES: This study was designed to assess the temporal changes in vagal responses to atrial premature beats before spontaneous onset of atrial fibrillation (AF). BACKGROUND: Enhanced vagal activity plays a major role in the onset and perpetuation of experimental AF, but the role of vagal activation in the onset of clinical AF episodes is not so well established. METHODS: We calculated heart rate turbulence after atrial premature impulses occurring 0 to 60 min before the onset of AF ("prior to AF") and compared it with the hourly means of the other hours of the 24-h electrocardiogram recordings ("non-AF hours") in 39 patients with structural heart disease and 29 patients with lone AF. Traditional heart rate variability measurements and approximate entropy (ApEn) were also analyzed. RESULTS: Turbulence onset (TO) was significantly less negative during the 1 h preceding AF than during the non-AF hours (0.71 +/- 1.76 vs. -0.35 +/- 1.46, p < 0.00001). Less negative TO before AF was observed among both the patients with structural heart disease (1.16 +/- 1.73 vs. 0.07 +/- 1.23; p < 0.0001) and those with lone AF (0.17 +/- 1.67 vs. -0.85 +/- 1.56; p < 0.0001). No significant difference was seen in the turbulence slope between the two periods, and none of the traditional frequency and time domain measurements differentiated between the periods; ApEn was significantly lower before AF than during the non-AF hours (p < 0.01). CONCLUSIONS: Altered heart rate dynamics, suggesting transient enhancement of vagal outflow after premature atrial excitation, are temporally related to spontaneous onset of clinical AF.
Authors: Hisaki Makimoto; Christian Blockhaus; Christian Meyer; Tina Lin; Christiane Jungen; Christian Eickholt; Lukas Clasen; Jan Schmidt; Muhammed Kurt; Patrick Müller; Dong-In Shin; Malte Kelm; Alexander Fürnkranz Journal: Int J Cardiol Heart Vasc Date: 2018-02-26
Authors: Peter Hämmerle; Christian Eick; Steffen Blum; Vincent Schlageter; Axel Bauer; Konstantinos D Rizas; Ceylan Eken; Michael Coslovsky; Stefanie Aeschbacher; Philipp Krisai; Pascal Meyre; Jean-Marc Vesin; Nicolas Rodondi; Elisavet Moutzouri; Jürg Beer; Giorgio Moschovitis; Richard Kobza; Marcello Di Valentino; Valentina D A Corino; Rita Laureanti; Luca Mainardi; Leo H Bonati; Christian Sticherling; David Conen; Stefan Osswald; Michael Kühne; Christine S Zuern Journal: J Am Heart Assoc Date: 2020-07-28 Impact factor: 5.501