Why the study?
How do the short-term dynamics of RR and systolic arterial pressure change during rest, tilt, and after restoration of sinus rhythm in patients with persistent atrial fibrillation?
How do the short-term dynamics of RR and systolic arterial pressure change during rest, tilt, and after restoration of sinus rhythm in patients with persistent atrial fibrillation?
In patients with persistent AF, systolic arterial pressure short-term dynamics change significantly during tilt compared to rest, whereas RR series dynamics remain unchanged despite a decrease in mean RR.
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SAP dynamics shift more than RR during tilt in persistent AF; hypothesis-generating and should not yet change practice.
BACKGROUND: During atrial fibrillation (AF), ventricular response is highly irregular and thus the beat-to-beat variation of blood pressure is increased because of variations in filling time and in contractility. OBJECTIVES: Aim of the present study is to investigate the short-term dynamics of RR and SAP series in patients with AF, during rest and tilt, and after restoration of sinus rhythm. METHODS: We computed symbolic sequences of the three phases, as they retain important features of the dynamics generated by the underlying control system. Then we applied a method based on rank order statistics of symbolic sequences to investigate the profile of different types of dynamics. The linguistic distance (range 0-1) between sequences represents a measure of similarity to assess whether the different physiological states are reflected on the dynamics of RR and SAP series. RESULTS: The distance between rest and tilt phases is 0.06 ± 0.02 for RR series, meaning they are very similar, while it is 0.21 ± 0.13 for SAP series, showing a difference in the short-term dynamics. RR mean decreases during tilt (738 ± 164 vs. 692 ± 152 ms, p <0.05, rest vs. tilt), while mean SAP is not significantly different (101 ± 20 vs. 104 ± 14 mmHg, rest vs. tilt). Comparing AF and sinus rhythm, both RR and SAP series result different in terms of the computed distance. CONCLUSIONS: SAP short-term dynamics seem to significantly change when comparing rest and tilt phases, while RR series remain unchanged. Moreover, RR mean but not SAP series significantly decreases during tilt.
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Belletti et al. (2010) studied this question.
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