Importance of vagal tone before atrial fibrillation onset

High-resolution digital Holter recording was carried out in 21 patients (15 men, 64 ± 12 yr) with chronic atrial fibrillation. Dominating atrial cycle length (DACL) was derived by frequency domain analysis of QRST-reduced electrocardiograms. Daytime mean DACL was 150 ± 17 ms, and nighttime mean was 157 ± 22 ms ( P = 0.0002). Diurnal fluctuation in DACL differed among patients: it tended to be virtually absent in those with a short mean DACL, but in those with longer DACL the night-day difference was as much as 23 ms ( R = 0.72, P < 0.001, correlation of mean DACL to night-day difference). Mean DACL also correlated with ventricular cycle length ( R = 0.40, P < 0.001), particularly at night ( r = 0.49). The shorter cycle lengths found in this study during the day are consistent with sympathetic and/or other physiological modulation, but since increased vagal tone shortens atrial refractoriness in most models, parasympathetic influences are not likely to play a major role. Alternatively, atrial effective refractory period may not be the sole determinant of atrial cycle length during atrial fibrillation.

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High vagal tone predicts pulmonary vein reconnection after cryoballoon ablation for paroxysmal atrial fibrillation

Pacing and Clinical Electrophysiology ◽

10.1111/pace.14408 ◽

2021 ◽

Author(s):

Paul‐Adrian Călburean ◽

Thiago Guimaraes Osorio ◽

Antonio Sorgente ◽

Alexandre Almorad ◽

Luigi Pannone ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Paroxysmal Atrial Fibrillation ◽

Vagal Tone ◽

Cryoballoon Ablation ◽

Pulmonary Vein Reconnection

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Low vagal tone and supraventricular ectopic activity predict atrial fibrillation and flutter after coronary artery bypass grafting

European Heart Journal ◽

10.1093/oxfordjournals.eurheartj.a061002 ◽

1995 ◽

Vol 16 (6) ◽

pp. 825-831 ◽

Cited By ~ 39

Author(s):

L. FROST ◽

H. MØLGAARD ◽

E. H. CHRISTIANSEN ◽

C.-J. JACOBSEN ◽

H. ALLERMAND ◽

...

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Vagal Tone ◽

Bypass Grafting ◽

Ectopic Activity ◽

Artery Bypass Grafting ◽

Atrial Fibrillation And Flutter

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Supraventricular Arrhythmias in Athletes: Basic Mechanisms and New Directions

Physiology ◽

10.1152/physiol.00009.2019 ◽

2019 ◽

Vol 34 (5) ◽

pp. 314-326 ◽

Cited By ~ 1

Author(s):

Alicia D’Souza ◽

Tariq Trussell ◽

Gwilym M. Morris ◽

Halina Dobrzynski ◽

Mark R. Boyett

Keyword(s):

Atrial Fibrillation ◽

Animal Models ◽

Heart Block ◽

Research Agenda ◽

Sinus Bradycardia ◽

Vagal Tone ◽

Supporting Evidence ◽

Supraventricular Arrhythmias ◽

Future Directions ◽

New Directions

Athletes are prone to supraventricular rhythm disturbances including sinus bradycardia, heart block, and atrial fibrillation. Mechanistically, this is attributed to high vagal tone and cardiac electrical and structural remodeling. Here, we consider the supporting evidence for these three pro-arrhythmic mechanisms in athletic human cohorts and animal models, featuring current controversies, emerging data, and future directions of relevance to the translational research agenda.

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Atrial fibrillation and physical activity

Orvosi Hetilap ◽

10.1556/oh.2013.29554 ◽

2013 ◽

Vol 154 (13) ◽

pp. 503-509

Author(s):

Péter Apor

Keyword(s):

Oxidative Stress ◽

Physical Activity ◽

Atrial Fibrillation ◽

Vagal Tone ◽

Protective Role ◽

Mental Illnesses ◽

Endurance Sports ◽

Inflammatory Processes ◽

Regular Medium ◽

Underlying Pathology

Atrial fibrillation is the most frequent arrhythmia. Its „lone” form (when underlying pathology is not discovered) can be detected in a few percent of endurance sports participants, and in growing occurrence among the veterans, probably on the basis of some cardiac or other irregularities. Enhanced vagal tone and sudden sympathetic impulse, repetitive oxidative stress, inflammatory processes, enlarged atria, electric instabilization can explain the higher occurrence. Treatment of atrial fibrillation enables the affected persons to participate in regular medium-intensity exercise, 3–5 hours a week, which offers a protective role against cardiovascular, metabolic and mental illnesses. Orv. Hetil., 2013, 154, 503–509.

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Vagal Tone: How Important Is It in Triggering Atrial Fibrillation?

Cardiac Arrhythmias 1997 ◽

10.1007/978-88-470-2288-1_2 ◽

1998 ◽

pp. 12-17

Author(s):

A. Capucci ◽

G. Q. Villani ◽

D. Aschieri ◽

A. Rosi

Keyword(s):

Atrial Fibrillation ◽

Vagal Tone

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Alcohol and Vagal Tone as Triggers for Paroxysmal Atrial Fibrillation

The American Journal of Cardiology ◽

10.1016/j.amjcard.2012.03.033 ◽

2012 ◽

Vol 110 (3) ◽

pp. 364-368 ◽

Cited By ~ 42

Author(s):

Mala C. Mandyam ◽

Vasanth Vedantham ◽

Melvin M. Scheinman ◽

Zian H. Tseng ◽

Nitish Badhwar ◽

...

Keyword(s):

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Vagal Tone

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Instantly Converting Atrial Fibrillation into Sinus Rhythm by a Digital Rectal Exam on a 29-year-Old Male

Clinical Medicine Insights Case Reports ◽

10.1177/117954761000300001 ◽

2010 ◽

Vol 3 ◽

pp. 117954761000300

Author(s):

Cheng-Huai Ruan

Keyword(s):

Atrial Fibrillation ◽

Sinus Rhythm ◽

Supraventricular Tachycardia ◽

Vagal Tone ◽

Risk Profile ◽

Electrical Cardioversion ◽

Digital Rectal Exam

Vagal maneuvers cause increase in vagal tone, which has been shown to slow many types supraventricular tachycardia, such as atrial fibrillation (AF). However, the conversion of AF to sinus rhythm is usually not associated with vagal manuvers. Thus, AF is classically treated with medication and electrical cardioversion. Here, we present a 29-year-old male with no cardiovascular history and a low atherosclerotic risk profile who developed AF which converted into sinus rhythm immediately after a digital rectal exam. The patient remained asymptomatic after a 3-month follow-up. This implies that the digital rectal exam can be considered as an additional attempt to convert AF to sinus rhythm in AF patients.

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