Document Detail


Reversed circadian rhythms of heart rate variability and morning peak occurrence of sustained ventricular tachyarrhythmias in patients with implanted cardioverter defibrillator.
MedLine Citation:
PMID:  12444379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is generally supposed that diurnal fluctuations of heart rate variability (HRV) are associated with diurnal variability of occurrence of sudden cardiac death, usually caused by tachyarrhythmias. To date, however, there have been no data comparing circadian rhythms of HRV and circadian variability of malignant ventricular tachyarrhythmias in the same patients. MATERIAL/METHODS: We studied 20 consecutive recipients of implantable cardioverter defibrillators in long-term follow-up, comparing the circadian rhythms of HRV in patients with and without typical morning peak occurrence of ventricular tachyarrhythmias. RESULTS: The HRV marker of vagus activity (RMSSD and HF power) displayed physiological circadian variability (highest values during sleep time, morning dip) only in patients without morning peak of arrhythmic events, and inverse circadian variability in patients with tachyarrhythmic morning peak. The variations in LF power and LF/HF ratio in both groups were not statistically significant, but with respect to the time interval between midnight and noon again showed inverse diurnal variation in patients with and without morning peak of arrhythmic events. CONCLUSIONS: These data suggest an association between a reversed circadian rhythm of HRV and morning peak frequency of tachyarrhythmic events in patients with ICD. As pronounced adrenergic hyperactivity in heart failure is the probable reason for paradoxically reversed circadian HRV variation, this association supports the hypothesis that the morning peak frequency of cardiovascular events may be interpreted as a sign of cardiovascular overload by the natural change from sleep to activity after awakening.
Authors:
Roland Fries; Sandra Hein; Jochem K nig
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical science monitor : international medical journal of experimental and clinical research     Volume:  8     ISSN:  1234-1010     ISO Abbreviation:  Med. Sci. Monit.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-21     Completed Date:  2003-05-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9609063     Medline TA:  Med Sci Monit     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  CR751-6     Citation Subset:  IM    
Affiliation:
Medical Clinic, Internal Medicine III, Cardiology/Angiology, Saarland University Clinics, Homburg/Saar, Germany. fries@med-in.uni-saarland.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Circadian Rhythm*
Defibrillators, Implantable*
Female
Follow-Up Studies
Heart Rate
Humans
Male
Middle Aged
Tachycardia, Ventricular / physiopathology*,  therapy
Time Factors
Comments/Corrections
Comment In:
Med Sci Monit. 2003 Feb;9(2):LE1; author reply LE2   [PMID:  12643268 ]

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


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