Key result
Vagus-mediated PAF is linked to progressive vagal tone increases and HRV changes 60 minutes before onset.
Why the study?
Variations of heart rate variability before paroxysmal atrial fibrillation onset remain controversial and require further investigation.
Do autonomic tone variations, as measured by heart rate variability, precede the onset of paroxysmal atrial fibrillation?
Observational (n=100)
Do autonomic tone variations, as measured by heart rate variability, precede the onset of paroxysmal atrial fibrillation?
Patients with vagally mediated paroxysmal atrial fibrillation exhibit a progressive increase in vagal tone during the 60 minutes prior to arrhythmia onset, which may inform future preventative interventions.
HRV shifts may flag impending vagal PAF; hypothesis-generating for targeted monitoring before clinical adoption.
BACKGROUND Variations of heart rate variability (HRV) before paroxysmal atrial fibrillation (PAF) onset are still controversial. We aimed to observe the autonomic tone variations before PAF onset based on HRV analysis. MATERIAL AND METHODS We prospectively investigated 24-h Holter recordings of 60 patients with PAF (M/F: 34/26) and 40 healthy people in sinus rhythm (M/F: 18/12). According to clinical information and Poincare scatter plot, 60 PAF patients were divided into sympathetic group (n=20) and vagus group (n=40). Time domain and frequency domain parameters of HRV were respectively measured before PAF episodes in 3 subgroups. Five time periods were studied using the ANOVA. RESULTS No significant variations were observed for the HRV parameters during 60 minutes preceding PAF in sympathetic group. A significant and linear change in SDNN, RMSSD, PNN50, HF and LF/HF during 60 minutes preceding PAF onset in vagus group. Compared with controls, RMSSD, LF and HF were significantly longer in patients with PAF during 60 minutes before PAF. Comparing sympathetic group and vagus group, we observed the same pattern of autonomic variations with a progressive decrease in LF and HF. A progressive decrease in PNN50 and LF/HF of sympathetic group and a significant increase in PNN50 and LF/HF of vagus group were also observed. CONCLUSIONS Patients with PAF mediated by different autonomic nerves have HRV variations, especially vagus PAF, there was a progressive increase with vagal tone during 60 minutes before PAF onset. The findings may help clinicians better intervene in PAF.
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A 2021 study conducted an observational in Paroxysmal Atrial Fibrillation (n=100). Paroxysmal atrial fibrillation vs. Healthy controls was evaluated on Heart rate variability (HRV) parameters during 60 minutes preceding PAF onset. Vagus-mediated paroxysmal atrial fibrillation was associated with a progressive increase in vagal tone and significant linear changes in heart rate variability during the 60 minutes before onset.
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