Takashi Kusayama1, Anthony Douglas2, Juyi Wan3, Anisiia Doytchinova4, Johnson Wong2, Gloria Mitscher2, Susan Straka2, Changyu Shen5, Thomas H Everett2, Peng-Sheng Chen6. 1. Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiovascular Medicine, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan. 2. Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. 3. Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China. 4. The Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, Ohio. 5. The Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 6. Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: chenpp@iu.edu.
Abstract
BACKGROUND: The relationship between the ventricular rate (VR) during atrial fibrillation (AF) and skin sympathetic nerve activity (SKNA) remains unclear. OBJECTIVE: The purpose of this study was to test the hypothesis that SKNA bursts accelerate VR during AF. METHODS: We simultaneously recorded electrocardiogram and SKNA in 8 patients (median age 66.0 years [interquartile range {IQR} 59.0-77.0 years]; 4 men [50%]) with 30 paroxysmal AF episodes (all >10-minute long) and 12 patients (73.0 years [IQR 60.5-80.0 years]; 6 men [50%]) with persistent AF. The average amplitude of SKNA (aSKNA [μV]) during AF was analyzed in 1-minute windows and binned, showing 2 Gaussian distributions. We used the mean + 3SD of the first Gaussian distribution as the threshold that separates burst from baseline (nonburst) SKNA. All 1-minute aSKNA values above the threshold were detected, and the area between aSKNA and baseline of every 1 minute was calculated and added as burst area. RESULTS: VR was higher during SKNA bursts than during the nonburst period (103 beats/min [IQR 83-113 beats/min] vs 88 beats/min [IQR 76-101 beats/min], respectively; P = .003). In the highest quartile of the burst area during persistent AF, the scatterplot of maximal aSKNA and VR during each SKNA burst shows higher aSKNA and VR. The overall estimate of the correlation between maximal VR and aSKNA during bursts show a positive correlation in the highest quartile of the burst area (0.64; 95% confidence interval 0.54-0.74; P < .0001). CONCLUSION: SKNA bursts are associated with VR acceleration. These SKNA bursts may be new therapeutic targets for rate control during AF.
BACKGROUND: The relationship between the ventricular rate (VR) during atrial fibrillation (AF) and skin sympathetic nerve activity (SKNA) remains unclear. OBJECTIVE: The purpose of this study was to test the hypothesis that SKNA bursts accelerate VR during AF. METHODS: We simultaneously recorded electrocardiogram and SKNA in 8 patients (median age 66.0 years [interquartile range {IQR} 59.0-77.0 years]; 4 men [50%]) with 30 paroxysmal AF episodes (all >10-minute long) and 12 patients (73.0 years [IQR 60.5-80.0 years]; 6 men [50%]) with persistent AF. The average amplitude of SKNA (aSKNA [μV]) during AF was analyzed in 1-minute windows and binned, showing 2 Gaussian distributions. We used the mean + 3SD of the first Gaussian distribution as the threshold that separates burst from baseline (nonburst) SKNA. All 1-minute aSKNA values above the threshold were detected, and the area between aSKNA and baseline of every 1 minute was calculated and added as burst area. RESULTS: VR was higher during SKNA bursts than during the nonburst period (103 beats/min [IQR 83-113 beats/min] vs 88 beats/min [IQR 76-101 beats/min], respectively; P = .003). In the highest quartile of the burst area during persistent AF, the scatterplot of maximal aSKNA and VR during each SKNA burst shows higher aSKNA and VR. The overall estimate of the correlation between maximal VR and aSKNA during bursts show a positive correlation in the highest quartile of the burst area (0.64; 95% confidence interval 0.54-0.74; P < .0001). CONCLUSION:SKNA bursts are associated with VR acceleration. These SKNA bursts may be new therapeutic targets for rate control during AF.
Authors: Zhaolei Jiang; Ye Zhao; Wei-Chung Tsai; Yuan Yuan; Kroekkiat Chinda; Jian Tan; Patrick Onkka; Changyu Shen; Lan S Chen; Michael C Fishbein; Shien-Fong Lin; Peng-Sheng Chen; Thomas H Everett Journal: JACC Clin Electrophysiol Date: 2018-06-27
Authors: Zhaolei Jiang; Ye Zhao; Anisiia Doytchinova; Nicholas J Kamp; Wei-Chung Tsai; Yuan Yuan; David Adams; David Wagner; Changyu Shen; Lan S Chen; Thomas H Everett; Shien-Fong Lin; Peng-Sheng Chen Journal: Heart Rhythm Date: 2015-02-11 Impact factor: 6.343
Authors: Eric A Robinson; Kyoung-Suk Rhee; Anisiia Doytchinova; Mohineesh Kumar; Richard Shelton; Zhaolei Jiang; Nicholas J Kamp; David Adams; David Wagner; Changyu Shen; Lan S Chen; Thomas H Everett; Michael C Fishbein; Shien-Fong Lin; Peng-Sheng Chen Journal: J Cardiovasc Electrophysiol Date: 2014-09-04
Authors: Anisiia Doytchinova; Jonathan L Hassel; Yuan Yuan; Hongbo Lin; Dechun Yin; David Adams; Susan Straka; Keith Wright; Kimberly Smith; David Wagner; Changyu Shen; Vicenta Salanova; Chad Meshberger; Lan S Chen; John C Kincaid; Arthur C Coffey; Gang Wu; Yan Li; Richard J Kovacs; Thomas H Everett; Ronald Victor; Yong-Mei Cha; Shien-Fong Lin; Peng-Sheng Chen Journal: Heart Rhythm Date: 2016-09-23 Impact factor: 6.343