Key Points
- This study aims to examine changes in sympatho-vagal balance right before atrial fibrillation occurs.
- Evaluated 28 patients with no heart disease history during 24-hour ECG Holter monitoring.
- Analyzed heart rate variability parameters five minutes prior to atrial fibrillation onset compared to one hour after.
- Recorded 36 separate episodes of atrial fibrillation and classified response types.
- Type A episodes showed a significant increase in low frequency (LF) (79.15 vs. 62.64, P = 0.004) and a decrease in high frequency (HF) (20.82 vs. 37.64, P = 0.004), indicating sympathetic activation.
- Type B episodes revealed a decrease in LF (62.82 vs. 85.97, P < 0.001) and an increase in HF (36.79 vs. 14.01, P < 0.001), indicating parasympathetic activation.
- Observed changes in neurogenic drive suggest dynamic autonomic regulation just before atrial fibrillation.
Structured PICO
PPopulation28 patients with no history of heart disease, not undergoing pharmacological treatment, who had at least one episode of paroxysmal atrial fibrillation recorded during 24-hour ECG Holter monitoring.
CComparatorEquivalent period at least 1 hour after atrial fibrillation (random period)
OOutcomeValues of frequency domain heart rate variability parameters (LF, HF) 5 minutes before the onset of atrial fibrillationsurrogate
Abrupt changes in sympathovagal balance, characterized by either increased sympathetic or parasympathetic drive, precede the onset of paroxysmal atrial fibrillation in patients without structural heart disease.