Cargando…

Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?

Sinus node dysfunction (SND) causes significant morbidity in patients after Fontan surgery. Heart rate variability (HRV) reflects the autonomic regulation of the heart, and changes in HRV have been associated with SND in adults. We aimed to study whether changes in HRV could be detected in 24-h elec...

Descripción completa

Detalles Bibliográficos
Autores principales: Dahlqvist, Jenny Alenius, Wiklund, Urban, Karlsson, Marcus, Hanséus, Katarina, Strömvall-Larsson, Eva, Nygren, Anders, Eliasson, Håkan, Rydberg, Annika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451711/
https://www.ncbi.nlm.nih.gov/pubmed/30918992
http://dx.doi.org/10.1007/s00246-019-02092-5
_version_ 1783409201763057664
author Dahlqvist, Jenny Alenius
Wiklund, Urban
Karlsson, Marcus
Hanséus, Katarina
Strömvall-Larsson, Eva
Nygren, Anders
Eliasson, Håkan
Rydberg, Annika
author_facet Dahlqvist, Jenny Alenius
Wiklund, Urban
Karlsson, Marcus
Hanséus, Katarina
Strömvall-Larsson, Eva
Nygren, Anders
Eliasson, Håkan
Rydberg, Annika
author_sort Dahlqvist, Jenny Alenius
collection PubMed
description Sinus node dysfunction (SND) causes significant morbidity in patients after Fontan surgery. Heart rate variability (HRV) reflects the autonomic regulation of the heart, and changes in HRV have been associated with SND in adults. We aimed to study whether changes in HRV could be detected in 24-h electrocardiographic (ECG) recordings in Fontan patients with SND. We compared HRV results from two patient groups; patients with Fontan circulation who later required a pacemaker due to severe SND (n = 12) and patients with Fontan circulation and SND, without indication for pacemaker treatment (n = 11), with two control groups; patients with Fontan circulation without SND (n = 90) and healthy controls (n = 66). The Poincaré plot index SD2 (representing changes in heart rate over 24-h) and the very low-frequency (VLF) HRV component were significantly higher in both SND groups, both compared with healthy controls and patients with Fontan circulation without SND. In SND patients with pacemakers, SD2 and VLF were slightly reduced compared to SND patients without pacemaker (p = 0.06). In conclusion, in Fontan patients with SND the HRV is significantly higher compared to healthy controls and Fontan patients without SND. However, in patients with severe SND requiring pacemaker, SD2 and VLF tended to be lower than in patients with SND without pacemaker, which could indicate a reduced diurnal HRV in addition to the severe bradycardia. This is a small study, but our results indicate that HRV analysis might be a useful method in the follow-up of Fontan patients regarding development of SND. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00246-019-02092-5) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-6451711
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-64517112019-04-17 Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation? Dahlqvist, Jenny Alenius Wiklund, Urban Karlsson, Marcus Hanséus, Katarina Strömvall-Larsson, Eva Nygren, Anders Eliasson, Håkan Rydberg, Annika Pediatr Cardiol Original Article Sinus node dysfunction (SND) causes significant morbidity in patients after Fontan surgery. Heart rate variability (HRV) reflects the autonomic regulation of the heart, and changes in HRV have been associated with SND in adults. We aimed to study whether changes in HRV could be detected in 24-h electrocardiographic (ECG) recordings in Fontan patients with SND. We compared HRV results from two patient groups; patients with Fontan circulation who later required a pacemaker due to severe SND (n = 12) and patients with Fontan circulation and SND, without indication for pacemaker treatment (n = 11), with two control groups; patients with Fontan circulation without SND (n = 90) and healthy controls (n = 66). The Poincaré plot index SD2 (representing changes in heart rate over 24-h) and the very low-frequency (VLF) HRV component were significantly higher in both SND groups, both compared with healthy controls and patients with Fontan circulation without SND. In SND patients with pacemakers, SD2 and VLF were slightly reduced compared to SND patients without pacemaker (p = 0.06). In conclusion, in Fontan patients with SND the HRV is significantly higher compared to healthy controls and Fontan patients without SND. However, in patients with severe SND requiring pacemaker, SD2 and VLF tended to be lower than in patients with SND without pacemaker, which could indicate a reduced diurnal HRV in addition to the severe bradycardia. This is a small study, but our results indicate that HRV analysis might be a useful method in the follow-up of Fontan patients regarding development of SND. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00246-019-02092-5) contains supplementary material, which is available to authorized users. Springer US 2019-03-27 2019 /pmc/articles/PMC6451711/ /pubmed/30918992 http://dx.doi.org/10.1007/s00246-019-02092-5 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Dahlqvist, Jenny Alenius
Wiklund, Urban
Karlsson, Marcus
Hanséus, Katarina
Strömvall-Larsson, Eva
Nygren, Anders
Eliasson, Håkan
Rydberg, Annika
Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?
title Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?
title_full Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?
title_fullStr Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?
title_full_unstemmed Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?
title_short Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation?
title_sort sinus node dysfunction in patients with fontan circulation: could heart rate variability be a predictor for pacemaker implantation?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451711/
https://www.ncbi.nlm.nih.gov/pubmed/30918992
http://dx.doi.org/10.1007/s00246-019-02092-5
work_keys_str_mv AT dahlqvistjennyalenius sinusnodedysfunctioninpatientswithfontancirculationcouldheartratevariabilitybeapredictorforpacemakerimplantation
AT wiklundurban sinusnodedysfunctioninpatientswithfontancirculationcouldheartratevariabilitybeapredictorforpacemakerimplantation
AT karlssonmarcus sinusnodedysfunctioninpatientswithfontancirculationcouldheartratevariabilitybeapredictorforpacemakerimplantation
AT hanseuskatarina sinusnodedysfunctioninpatientswithfontancirculationcouldheartratevariabilitybeapredictorforpacemakerimplantation
AT stromvalllarssoneva sinusnodedysfunctioninpatientswithfontancirculationcouldheartratevariabilitybeapredictorforpacemakerimplantation
AT nygrenanders sinusnodedysfunctioninpatientswithfontancirculationcouldheartratevariabilitybeapredictorforpacemakerimplantation
AT eliassonhakan sinusnodedysfunctioninpatientswithfontancirculationcouldheartratevariabilitybeapredictorforpacemakerimplantation
AT rydbergannika sinusnodedysfunctioninpatientswithfontancirculationcouldheartratevariabilitybeapredictorforpacemakerimplantation