Key result
Paroxysmal atrial fibrillation development in acute ischemic stroke patients was associated with significantly higher parasympathetic activity and a lower LF/HF ratio (p<0.001).
Why the study?
To evaluate the usefulness of heart rate variability spectral analysis as a predictor of covert paroxysmal atrial fibrillation in patients with cryptogenic stroke.
Does heart rate variability spectral analysis predict covert paroxysmal atrial fibrillation in patients with cryptogenic stroke?
Observational (n=77)
No
Does heart rate variability spectral analysis predict covert paroxysmal atrial fibrillation in patients with cryptogenic stroke?
Heart rate variability spectral analysis indicates that parasympathetic activity is predominant in the acute phase of ischemic stroke patients with PAF, with sympathetic activity becoming predominant immediately preceding PAF occurrence.
HRV spectral analysis may flag PAF risk in acute stroke; leaves open predictive value for covert AF in cryptogenic stroke.
We examined the usefulness of heart rate variability spectral analysis as a predictor of covert paroxysmal atrial fibrillation (PAF), an essential risk factor for embolic stroke. Between July 2021 and January 2022, 77 patients (mean age, 76.3 ± 10.9 years) hospitalized with cryptogenic stroke within 3 days of symptom onset were monitored by telemetry electrocardiogram (ECG) transmitter Duranta®. Autonomic nervous activity up to maximum 30 days after monitoring by Duranta® was analyzed and PAF was detected in 8 patients. During 24-hour post-monitoring, 8 patients with PAF had significantly higher levels of low-frequency components (LF), high-frequency components (HF), and HF normalization units and significantly lower levels of LF/HF ratio than those without PAF. Conversely, the results showed the trend of LF/HF ratio to increase and the HF values to decrease preceding the onset of PAF. These findings suggest that parasympathetic activity is predominant in the acute phase of ischemic stroke patients with PAF, but sympathetic activity become predominant towards the PAF occurrence.
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Komine et al. (2022) conducted an observational in Cryptogenic stroke (n=77). Paroxysmal atrial fibrillation (PAF) vs. Without PAF was evaluated on LF/HF ratio (indicator of sympathetic nervous activity) (p=<0.001). Paroxysmal atrial fibrillation development in acute ischemic stroke patients was associated with significantly higher parasympathetic activity and a lower LF/HF ratio (p<0.001).
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