Abstract:
INTRODUCTION:This study was designed to analyze dynamic changes in autonomic tone preceding the onset of sustained atrial arrhythmias in patients with focal atrial fibrillation (AF) to determine why patients with frequent discharge from the arrhythmogenic foci develop sustained AF. METHODS AND RESULTS:Holter tapes from 13 patients (10 men and 3 women; mean age 53 +/- 5 years) with paroxysmal "lone" AF (mean 18 +/- 13 episodes per week) and a proven focal origin (pulmonary veins in all cases) were analyzed. A total of 38 episodes of sustained (>30 min) were recorded and submitted to frequency-domain heart rate variability analysis. Six periods were studied using repeated measures analysis of variance: the 24-hour period, the hour preceding AF, and the 20 minutes before AF divided into four 5-minute periods. A significant increase in high-frequency (HF, HF-NU) components was observed during the 20 minutes preceding AF (P = 0.003 and 0.002, respectively), together with a progressive decrease in normalized low-frequency (LF-NU) components (P = 0.035). An increase in LF/HF ratio followed by a linear decrease starting 15 minutes before sustained AF also was observed, indicating fluctuations in autonomic tone, with a primary increase in adrenergic drive followed by a marked modulation toward vagal predominance immediately before AF onset. CONCLUSION:In patients with focal ectopy originating from the pulmonary veins, sustained episodes of atrial arrhythmias are mainly dependent on variations of autonomic tone, with a significant shift toward vagal predominance before AF onset.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Zimmermann M,Kalusche Ddoi
10.1046/j.1540-8167.2001.00285.xkeywords:
subject
Has Abstractpub_date
2001-03-01 00:00:00pages
285-91issue
3eissn
1045-3873issn
1540-8167journal_volume
12pub_type
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journal_title:Journal of cardiovascular electrophysiology
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更新日期:2004-08-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1999.tb00715.x
更新日期:1999-04-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2003-09-01 00:00:00
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更新日期:2016-06-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-04-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2015-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1046/j.1540-8167.14.s9.1.x
更新日期:2003-09-01 00:00:00
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更新日期:2011-07-01 00:00:00
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更新日期:2021-01-13 00:00:00
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更新日期:2003-01-01 00:00:00
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更新日期:2011-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2020-07-01 00:00:00
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更新日期:2013-05-01 00:00:00
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