BACKGROUND: Cardiac autonomic dysfunction is a common complication of familial amyloidotic polyneuropathy (FAP), but cardiac arrhythmia and conduction disturbances are also common. We analyzed heart rate variability (HRV) in FAP patients using power spectrum analysis and Poincaré plot analysis. METHODS: HRV was analyzed in 24-hour ECG recordings (Holter) in 41 FAP patients. RESULTS: Power spectrum analysis showed reduced HRV in 21 FAP patients. A novel finding was that nine other patients with abnormal Poincaré plots had either very high power in the high-frequency region (0.15-0.50 Hz) or broadband HRV power spectra without any distinctive spectral peaks. Reanalysis of their ECGs showed a previously undetected intermittent atrial arrhythmia. CONCLUSIONS: Subtle arrhythmias may be difficult to detect during analyses of Holter recordings. Patients with intermittent atrial arrhythmia were identified by broadband HRV spectra and abnormal Poincaré plots. High high-frequency power in HRV and irregular heart rate patterns may indicate the presence of subtle atrial arrhythmia. Consequently, such patients should be excluded from studies of cardiac autonomic modulation.
BACKGROUND:Cardiac autonomic dysfunction is a common complication of familial amyloidotic polyneuropathy (FAP), but cardiac arrhythmia and conduction disturbances are also common. We analyzed heart rate variability (HRV) in FAPpatients using power spectrum analysis and Poincaré plot analysis. METHODS: HRV was analyzed in 24-hour ECG recordings (Holter) in 41 FAPpatients. RESULTS: Power spectrum analysis showed reduced HRV in 21 FAPpatients. A novel finding was that nine other patients with abnormal Poincaré plots had either very high power in the high-frequency region (0.15-0.50 Hz) or broadband HRV power spectra without any distinctive spectral peaks. Reanalysis of their ECGs showed a previously undetected intermittent atrial arrhythmia. CONCLUSIONS:Subtle arrhythmias may be difficult to detect during analyses of Holter recordings. Patients with intermittent atrial arrhythmia were identified by broadband HRV spectra and abnormal Poincaré plots. High high-frequency power in HRV and irregular heart rate patterns may indicate the presence of subtle atrial arrhythmia. Consequently, such patients should be excluded from studies of cardiac autonomic modulation.
Authors: O Kinoshita; M Hongo; Y Saikawa; T Katsuyama; M Tanaka; M Takeda; H Yamamoto; M Isobe; M Sekiguchi Journal: Pacing Clin Electrophysiol Date: 1997-12 Impact factor: 1.976
Authors: Dan Wichterle; Jan Simek; Maria Teresa La Rovere; Peter J Schwartz; A John Camm; Marek Malik Journal: Circulation Date: 2004-08-16 Impact factor: 29.690
Authors: Maria K Svensson; Stina Lindmark; Urban Wiklund; Peter Rask; Marcus Karlsson; Jan Myrin; Joel Kullberg; Lars Johansson; Jan W Eriksson Journal: Cardiovasc Diabetol Date: 2016-06-28 Impact factor: 9.951
Authors: Alex P Carll; Samir M Crespo; Mauricio S Filho; Douglas H Zati; Brent A Coull; Edgar A Diaz; Rodrigo D Raimundo; Thomas N G Jaeger; Ana Laura Ricci-Vitor; Vasileios Papapostolou; Joy E Lawrence; David M Garner; Brigham S Perry; Jack R Harkema; John J Godleski Journal: Part Fibre Toxicol Date: 2017-05-25 Impact factor: 9.400