Document Detail

Abnormal vasovagal reaction, autonomic function, and heart rate variability in patients with paroxysmal atrial fibrillation.
MedLine Citation:
PMID:  9507539     Owner:  NLM     Status:  MEDLINE    
The aim of this study was to evaluate the cardiovascular autonomic function and vasovagal reaction in patients with paroxysmal atrial fibrillation without significant structural heart disease. Twenty-eight patients with paroxysmal atrial fibrillation (9 patients were categorized to have autonomic-mediated atrial fibrillation while atrial fibrillation in other patients was nonautonomic mediated) and 19 normal control subjects were recruited. Cardiovascular autonomic function tests included measuring heart rate response to standing, deep breathing, Valsalva maneuver, baroreflex sensitivity, 24-hour heart rate variability, and also head-up tilt test. Compared with normal subjects, no significant autonomic dysfunction was found in patients with autonomic-mediated and nonautonomic-mediated atrial fibrillation. All subjects had negative baseline tilt test. With isoproterenol provocation, six patients developed atrial fibrillation. Four of 9 patients and 3 of 19 patients with autonomic mediated and nonautonomic mediated atrial fibrillation had a positive tilt test respectively, while none occurred in the controls. A significant percentage (32%) of patients with paroxysmal atrial fibrillation had episodes of atrial fibrillation provoked by changes in autonomic tone, although there was no underlying abnormal cardiac autonomic function nor sympathetic-parasympathetic imbalance. A heightened susceptibility to vasovagal cardiovascular response may have important implications on the occurrence and symptomatology of patients with paroxysmal atrial fibrillation.
N S Lok; C P Lau
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  21     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-06-11     Completed Date:  1998-06-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  386-95     Citation Subset:  IM; S    
Department of Medicine, Queen Mary Hospital, Hong Kong.
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MeSH Terms
Aged, 80 and over
Analysis of Variance
Atrial Fibrillation / physiopathology*
Autonomic Nervous System / physiopathology*
Case-Control Studies
Exercise Test
Heart Rate*
Isoproterenol / diagnostic use
Middle Aged
Sympathomimetics / diagnostic use
Tilt-Table Test
Vagus Nerve / physiopathology
Vasomotor System / physiopathology
Reg. No./Substance:
0/Sympathomimetics; 7683-59-2/Isoproterenol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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