Key result
Parasympathetic modulation, evidenced by a significant decrease in vagal tone before heart rate acceleration and an increase before deceleration, plays a key role in the initiation of paroxysmal atrial fibrillation.
Why the study?
Does the pattern of autonomic modulation differ before the onset of paroxysmal atrial fibrillation depending on whether the heart rate accelerates or decelerates?
Observational (n=42)
Does the pattern of autonomic modulation differ before the onset of paroxysmal atrial fibrillation depending on whether the heart rate accelerates or decelerates?
Answers are grounded in this paper and cite their sources.
Autonomic stimuli leading to heart rate acceleration or deceleration before the onset of paroxysmal atrial fibrillation are primarily driven by parasympathetic modulation (vagal withdrawal or rebound).
BackgroundAn acceleration or deceleration of the heart rate (HR), which reflects autonomic effects, is observed before the onset of paroxysmal atrial fibrillation (PAF). The purpose of this study was to assess the discrepancy in the autonomic interactions before the onset of PAF for different patterns of change in the HR. Materials and MethodsFrom 105 Holter tapes with the PAF recorded, 55 episodes (42 patients, 34 men, 5812 years) of PAF (>5 min), preceded by a sinus rhythm for more than 1 hour, were selected and submitted to time-domain and frequency-domain HR variability analyses. Fifty-five episodes were divided into 2 groups: group A PAF (n=30) with acceleration of the HR during the last 2 minutes before the PAF and group B (n=25) with deceleration of the HR. 1)
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Lee et al. (2007) conducted an observational in Paroxysmal Atrial Fibrillation (n=42). Heart rate acceleration before PAF onset vs. Heart rate deceleration before PAF onset was evaluated on Mean R-R interval in Group A (acceleration) during the last 2 minutes before PAF compared to 20 minutes prior (p=0.001). Parasympathetic modulation, evidenced by a significant decrease in vagal tone before heart rate acceleration and an increase before deceleration, plays a key role in the initiation of paroxysmal atrial fibrillation.
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