Atrial fibrillation is associated with increased sympathetic activity, with patients in active AF showing significantly higher periodic repolarization dynamics (median 7.0 vs 4.8 degrees, p<0.001).
Does atrial fibrillation alter cardiac autonomic function assessed by heart rate variability in elderly patients?
Atrial fibrillation is associated with increased sympathetic activity and autonomic impairment, which is most pronounced during active AF episodes.
Absolute Event Rate: 0% vs 0%
Structured Abstract Background and Aims Cardiac autonomic dysfunction is associated with an adverse prognosis in patients with atrial fibrillation (AF). However, the association of AF itself with cardiac autonomic function (CAF) remains unclear. We aimed to investigate whether CAF, assessed by heart rate variability (HRV), differs across patients with and without AF. Methods We enrolled patients from a prospective multicenter study (Swiss-AF) with a 5-minute resting ECG recording in SR or AF without pacing. CAF was quantified by periodic repolarization dynamics (PRD), a marker of sympathetic activity, and by conventional HRV parameters. Results We included 2289 patients, 807 (35%) SR patients, 932 (41%) AF patients with SR ECGs (AF-SR) and 550 (24%) AF patients with AF ECGs (AF-AF). Mean age was 74 vs 70 vs 75 years, 37%, 31% and 24% were female. Median PRD was 4.8 deg (IQR 2.6-6.7) in the SR group, 5.1 deg (IQR 2.9-6.9) in the AF-SR group and 7.0 deg (IQR 5.8-8.4) in the AF-AF group (p 0.001). After full adjustment (SR group = reference group), the AF-AF group showed a stronger association with elevated PRD (β-coefficient 2.10, 95% CI 1.79-2.41, p0.001) than the AF-SR group (β-coefficient 0.36, 95% CI 0.08-0.64, p=0.011). Most other HRV parameters indicated greater autonomic impairment in the AF–SR group compared to the SR group. Conclusion AF was associated with increased sympathetic activity, with the greatest impairment observed in patients during AF, independent of cardiovascular risk factors. PRD may represent a useful marker for the assessment of CAF in AF patients.
Hämmerle et al. (Sun,) reported a other. Atrial fibrillation is associated with increased sympathetic activity, with patients in active AF showing significantly higher periodic repolarization dynamics (median 7.0 vs 4.8 degrees, p<0.001).