Document Detail


Impaired autonomic function predicts dizziness at onset of paroxysmal atrial fibrillation.
MedLine Citation:
PMID:  11744134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Paroxysmal atrial fibrillation is associated with various symptoms, including dizziness, which presumably reflects hemodynamic deterioration. Given the importance of the autonomic nervous system in mitigating the hemodynamic effect of atrial fibrillation, we hypothesized that autonomic function would be predictive of the severity of dizziness. METHODS: The study group comprised 73 patients with paroxysmal atrial fibrillation (mean age 54.1 years, 51 males). Forty-three (59%) patients had lone atrial fibrillation. Mean ventricular rate during atrial fibrillation was 99+/-16 beats/min. On average, patients had a 3-year history of one paroxysm per week lasting 2 h. Autonomic function was assessed using autonomic function tests, including noninvasive measurement of baroreflex sensitivity. Head up tilting was used to test vasovagal reactivity. Severity of dizziness at onset of atrial fibrillation was quantified by the patients using a five-point scale (1=none; 2=light; 3=mild; 4=moderate; and 5=severe). Multivariate analysis was performed to identify the independent predictors of the severity of dizziness. RESULTS: Mean severity of dizziness was 3.36+/-1.65. Multivariate predictors of moderate-to-severe dizziness as opposed to none-to-mild dizziness were a low 30-15 ratio after standing up and low baroreflex sensitivity. Though syncope was never reported nine patients showed a full vasovagal response during head up tilting. CONCLUSIONS: It is concluded that dizziness in patients with "treated" atrial fibrillation in the setting of none to mild structural heart disease is predicted by impaired autonomic function. Vasovagal reactivity appears not to be involved in this connection.
Authors:
M P van den Berg; R J Hassink; A E Tuinenburg; J D Lefrandt; P J de Kam; H J Crijns
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  81     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-17     Completed Date:  2002-01-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  175-80     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Thorax Center, University Hospital Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. m.p.van.den.berg@thorax.azg.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / complications*,  physiopathology*
Autonomic Nervous System Diseases / complications*,  physiopathology*
Blood Pressure / physiology
Dizziness / etiology*,  physiopathology*,  psychology
Female
Health Status Indicators
Humans
Male
Middle Aged
Predictive Value of Tests
Questionnaires
Sensitivity and Specificity
Severity of Illness Index
Valsalva Maneuver / physiology
Work of Breathing / physiology

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