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Cardiac Autonomic Dysfunction and Incidence of de novo Atrial Fibrillation: Heart Rate Variability vs. Heart Rate Complexity

BACKGROUND: The REACT DX registry evaluates standard therapies to episodes of long-lasting atrial tachyarrhythmias and assesses the quality of sensing and stability of the lead and the implantable cardioverter-defibrillator (ICD) (BIOTRONIK Lumax VR-T DX and successors) over at least a 1-year follow...

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Autores principales: Wessel, Niels, Berg, Karsten, Kraemer, Jan F., Gapelyuk, Andrej, Rietsch, Katrin, Hauser, Tino, Kurths, Jürgen, Wenzel, Dave, Klein, Norbert, Kolb, Christof, Belke, Roberto, Schirdewan, Alexander, Kääb, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752808/
https://www.ncbi.nlm.nih.gov/pubmed/33363477
http://dx.doi.org/10.3389/fphys.2020.596844
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author Wessel, Niels
Berg, Karsten
Kraemer, Jan F.
Gapelyuk, Andrej
Rietsch, Katrin
Hauser, Tino
Kurths, Jürgen
Wenzel, Dave
Klein, Norbert
Kolb, Christof
Belke, Roberto
Schirdewan, Alexander
Kääb, Stefan
author_facet Wessel, Niels
Berg, Karsten
Kraemer, Jan F.
Gapelyuk, Andrej
Rietsch, Katrin
Hauser, Tino
Kurths, Jürgen
Wenzel, Dave
Klein, Norbert
Kolb, Christof
Belke, Roberto
Schirdewan, Alexander
Kääb, Stefan
author_sort Wessel, Niels
collection PubMed
description BACKGROUND: The REACT DX registry evaluates standard therapies to episodes of long-lasting atrial tachyarrhythmias and assesses the quality of sensing and stability of the lead and the implantable cardioverter-defibrillator (ICD) (BIOTRONIK Lumax VR-T DX and successors) over at least a 1-year follow-up period. OBJECTIVE: To study the association between the risk of de novo device-detected atrial fibrillation (AF), the autonomic perturbations before the onset of paroxysmal AF and a 7-days heart rate variability (7dHRV) 1 month after ICD implantation. METHODS: The registry consists of 234 patients implanted with an ICD, including 10 with de novo long-lasting atrial tachyarrhythmias with no prior history of AF. The patients were matched via the propensity-score methodology as well as for properties directly influencing the ECGs recorded using GE CardioMem CM 3000. Heart rate variability (HRV) analysis was performed using standard parameters from time- and frequency-domains, and from non-linear dynamics. RESULTS: No linear HRV was associated with an increased risk of AF (p = n.s.). The only significant approach was derived from symbolic dynamics with the parameter “forbidden words” which distinguished both groups on all 7 days of measurements (p < 0.05), thereby quantifying the heart rate complexity (HRC) as drastically lower in the de novo AF group. CONCLUSION: Cardiac autonomic dysfunction denoted by low HRC may be associated with higher AF incidence. For patients with mild to moderate heart failure, standard HRV parameters are not appropriate to quantify cardiac autonomic perturbations before the onset of AF. Further studies are needed to determine the individual risk for AF that would enable interventions to restore autonomic balance in the general population.
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spelling pubmed-77528082020-12-23 Cardiac Autonomic Dysfunction and Incidence of de novo Atrial Fibrillation: Heart Rate Variability vs. Heart Rate Complexity Wessel, Niels Berg, Karsten Kraemer, Jan F. Gapelyuk, Andrej Rietsch, Katrin Hauser, Tino Kurths, Jürgen Wenzel, Dave Klein, Norbert Kolb, Christof Belke, Roberto Schirdewan, Alexander Kääb, Stefan Front Physiol Physiology BACKGROUND: The REACT DX registry evaluates standard therapies to episodes of long-lasting atrial tachyarrhythmias and assesses the quality of sensing and stability of the lead and the implantable cardioverter-defibrillator (ICD) (BIOTRONIK Lumax VR-T DX and successors) over at least a 1-year follow-up period. OBJECTIVE: To study the association between the risk of de novo device-detected atrial fibrillation (AF), the autonomic perturbations before the onset of paroxysmal AF and a 7-days heart rate variability (7dHRV) 1 month after ICD implantation. METHODS: The registry consists of 234 patients implanted with an ICD, including 10 with de novo long-lasting atrial tachyarrhythmias with no prior history of AF. The patients were matched via the propensity-score methodology as well as for properties directly influencing the ECGs recorded using GE CardioMem CM 3000. Heart rate variability (HRV) analysis was performed using standard parameters from time- and frequency-domains, and from non-linear dynamics. RESULTS: No linear HRV was associated with an increased risk of AF (p = n.s.). The only significant approach was derived from symbolic dynamics with the parameter “forbidden words” which distinguished both groups on all 7 days of measurements (p < 0.05), thereby quantifying the heart rate complexity (HRC) as drastically lower in the de novo AF group. CONCLUSION: Cardiac autonomic dysfunction denoted by low HRC may be associated with higher AF incidence. For patients with mild to moderate heart failure, standard HRV parameters are not appropriate to quantify cardiac autonomic perturbations before the onset of AF. Further studies are needed to determine the individual risk for AF that would enable interventions to restore autonomic balance in the general population. Frontiers Media S.A. 2020-12-08 /pmc/articles/PMC7752808/ /pubmed/33363477 http://dx.doi.org/10.3389/fphys.2020.596844 Text en Copyright © 2020 Wessel, Berg, Kraemer, Gapelyuk, Rietsch, Hauser, Kurths, Wenzel, Klein, Kolb, Belke, Schirdewan and Kääb. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Wessel, Niels
Berg, Karsten
Kraemer, Jan F.
Gapelyuk, Andrej
Rietsch, Katrin
Hauser, Tino
Kurths, Jürgen
Wenzel, Dave
Klein, Norbert
Kolb, Christof
Belke, Roberto
Schirdewan, Alexander
Kääb, Stefan
Cardiac Autonomic Dysfunction and Incidence of de novo Atrial Fibrillation: Heart Rate Variability vs. Heart Rate Complexity
title Cardiac Autonomic Dysfunction and Incidence of de novo Atrial Fibrillation: Heart Rate Variability vs. Heart Rate Complexity
title_full Cardiac Autonomic Dysfunction and Incidence of de novo Atrial Fibrillation: Heart Rate Variability vs. Heart Rate Complexity
title_fullStr Cardiac Autonomic Dysfunction and Incidence of de novo Atrial Fibrillation: Heart Rate Variability vs. Heart Rate Complexity
title_full_unstemmed Cardiac Autonomic Dysfunction and Incidence of de novo Atrial Fibrillation: Heart Rate Variability vs. Heart Rate Complexity
title_short Cardiac Autonomic Dysfunction and Incidence of de novo Atrial Fibrillation: Heart Rate Variability vs. Heart Rate Complexity
title_sort cardiac autonomic dysfunction and incidence of de novo atrial fibrillation: heart rate variability vs. heart rate complexity
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752808/
https://www.ncbi.nlm.nih.gov/pubmed/33363477
http://dx.doi.org/10.3389/fphys.2020.596844
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