Key result
Continuous monitoring of blood pressure in a patient with atrial fibrillation and heart failure showed that daily profiles (e.g., dipper, nondipper) can change within days, challenging their utility.
Case Report (n=1)
No
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Continuous BP monitoring reveals that daily BP profiles (e.g., dipper, nondipper) can change within days in a single patient, suggesting treatment timing should rely on real-time signal forms rather than static classifications.
Dynamics of blood pressure (BP) and heart rate (HR) was traced by automatic monitoring every 30 min uninterruptedly along several months in a patient suffering from combined atrial fibrillation and heart failure during the development of disease and its therapeutic and surgical treatment (pacemaker implanting and atrioventricular ablation). Analyses of spectral components as well as signal's shape revealed instabilities in circadian and semicircadian parameters. A new approach for signal's form description without using cosine approximation is suggested. The meaning that referring a patient as dipper, night peaker, or nondipper might be useful at choosing tactics of his treatment is impugned, because all these "types" can transform themselves in the same person in few days. Optimization timing of treatment provides better results if not the "types" of daily profile would be taken to account but the real form of the BP-signal and timing its first and second derivatives.
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Чибисов et al. (2013) conducted a case report in Atrial fibrillation and heart failure (n=1). Automatic monitoring of blood pressure and heart rate was evaluated on Circadian and semicircadian parameters of blood pressure and heart rate. Continuous monitoring of blood pressure in a patient with atrial fibrillation and heart failure showed that daily profiles (e.g., dipper, nondipper) can change within days, challenging their utility.
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