Document Detail

Fluctuation in autonomic tone is a major determinant of sustained atrial arrhythmias in patients with focal ectopy originating from the pulmonary veins.
MedLine Citation:
PMID:  11294170     Owner:  NLM     Status:  MEDLINE    
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.
M Zimmermann; D Kalusche
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  12     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-04-06     Completed Date:  2001-07-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  285-91     Citation Subset:  IM    
Cardiology Department, Hôpital de La tour, Meyrin, Switzerland.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis,  etiology*
Atrial Fibrillation / complications*,  physiopathology*,  surgery
Atrial Function*
Atrial Premature Complexes / complications*,  physiopathology*
Autonomic Nervous System / physiopathology*
Catheter Ablation
Electrocardiography, Ambulatory
Heart Rate
Middle Aged
Pulmonary Veins / physiopathology*
Comment In:
J Cardiovasc Electrophysiol. 2001 Mar;12(3):292-3   [PMID:  11291800 ]

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

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