scholarly journals Patients with reflex syncope have a higher prevalence of atrial fibrillation than general population which is predicted by the type of the tilt table test response

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J M Farinha ◽  
L Parreira ◽  
A F Esteves ◽  
M Fonseca ◽  
A Pinheiro ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
General Population ◽  
Tilt Test ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Test Response ◽  
Reflex Syncope ◽  
Vasodepressor Response

Abstract Introduction Reflex syncope is the result of an imbalance between the sympathetic and parasympathetic nervous system. The autonomic nervous system has been associated to some forms of atrial fibrillation (AF). Objective The aim of this study was to assess the prevalence of AF in patients with reflex syncope and a positive tilt table test and to identify the type of tilt test response in patients with AF in comparison to patients without AF. Methods We retrospectively studied consecutive patients that underwent a tilt table test at our institution between 2016 and 2019. We selected those patients with a positive test. Patients with an implanted pacemaker at the time of the tilt test and patients followed in a different institution were excluded. Previous diagnoses of AF episodes were assessed. We analysed the clinical characteristics and the tilt table test results according to previous history of AF. Results We studied 49 patients with a positive tilt test. Seven (14.3%) patients had previously diagnosed paroxysmal AF at the time of the tilt table test. Patients with AF were older, had more frequently hypertension, and the tilt test response was more frequently a vasodepressor than mixed or cardioinhibitory response (71.4% vs. 28.6%) (Table). In univariate analysis, age and hypertension were associated with AF, respectively, OR 1.08 (95% CI 1.01–1.17), p=0.034 and OR 10.80 (95% CI 1.19–98.36), p=0.035. A vasodepressor response was also associated with AF (OR 6.25, 95% CI 1.06–36.74, p=0.043). Conclusions Patients with reflex syncope and a positive tilt table test had a higher prevalence of AF than the general population. A vasodepressor response was associated with AF as were age and hypertension, demonstrating the possible impact of the autonomic nervous system and the multifactorial nature of AF. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Nonlinear and Conventional Biosignal Analyses Applied to Tilt Table Test for Evaluating Autonomic Nervous System and Autoregulation

2013 ◽  
Vol 7 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Li Tseng ◽  
Sung-Chun Tang ◽  
Chun-Yuan Chang ◽  
Yi-Ching Lin ◽  
Maysam F. Abbod ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Multiscale Entropy ◽  
Total Power ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Autonomic Nervous ◽  
Three Stages ◽  
Normal Controls ◽  
Better Than

Tilt table test (TTT) is a standard examination for patients with suspected autonomic nervous system (ANS) dysfunction or uncertain causes of syncope. Currently, the analytical method based on blood pressure (BP) or heart rate (HR) changes during the TTT is linear but normal physiological modulations of BP and HR are thought to be predominately nonlinear. Therefore, this study consists of two parts: the first part is analyzing the HR during TTT which is compared to three methods to distinguish normal controls and subjects with ANS dysfunction. The first method is power spectrum density (PSD), while the second method is detrended fluctuation analysis (DFA), and the third method is multiscale entropy (MSE) to calculate the complexity of system. The second part of the study is to analyze BP and cerebral blood flow velocity (CBFV) changes during TTT. Two measures were used to compare the results, namely correlation coefficient analysis (nMxa) and MSE. The first part of this study has concluded that the ratio of the low frequency power to total power of PSD, and MSE methods are better than DFA to distinguish the difference between normal controls and patients groups. While in the second part, the nMxa of the three stages moving average window is better than the nMxa with all three stages together. Furthermore the analysis of BP data using MSE is better than CBFV data.

scholarly journals Assessment of Quadratic Nonlinear Cardiorespiratory Couplings During Tilt Table Test by Means of Real Wavelet Biphase

2017 ◽  
Vol 5 ◽  
Author(s):  
Spyridon Kontaxis ◽  
Jesús Lázaro ◽  
Eduardo Gil ◽  
Pablo Laguna ◽  
Raquel Bailón
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Tilt Table Test ◽  
Phase Coupling ◽  
Tilt Table ◽  
Autonomic Nervous ◽  
Quadratic Phase Coupling ◽  
Quadratic Phase

In this paper a method for the assessment of Quadratic Phase Coupling (QPC) between respiration and Heart Rate Variability is presented and applied to study cardiorespiratory couplings during a tilt table test. Strong QPC related to the dominant respiratory frequency is present and remains unchanged during Autonomic Nervous System changes.

Association of Autonomic Nervous System Abnormalities on Head-Up Tilt Table Test with Joint Hypermobility

2018 ◽  
Vol 79 (5-6) ◽  
pp. 319-324 ◽  
Author(s):  
Ivan Adamec ◽  
Anamari Junakovic ◽  
Magdalena Krbot Skorić ◽  
Mario Habek
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Multivariate Regression Analysis ◽  
Joint Hypermobility ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Tilt Table Test ◽  
Tilt Table ◽  
Autonomic Nervous ◽  
Generalized Joint Hypermobility ◽  
Head Up Tilt

Aim: The aim of this study was to investigate the association of autonomic nervous system abnormalities on head-up tilt table test (HUTT) with generalized joint hypermobility, expressed by Beighton score (BS). Methods: This was a prospective study that included 115 consecutive patients (91 females; mean age 34.35 ± 14.11) referred either for the HUTT or testing of the cardiovascular autonomic reflexes together with HUTT. Generalized joint hypermobility was evaluated according to the BS system after which HUTT was performed. Clinically significant BS was considered if ≥4. Results: Fifteen patients (15.1%) had BS ≥4. Results of the HUTT were normal in 58 (50.4%) patients and in 57 (49.6%) patient HUTT was abnormal. Fifteen (13.0%) patients fulfilled criteria for orthostatic hypotension, 30 (26.1%) for reflex syncope and 21 (18.3%) for postural orthostatic tachycardia syndrome. Patients with pathological findings on HUTT had significantly higher BS compared to patients with normal HUTT (median 1 vs. 0, p = 0.001). There was a significant association between participants with BS ≥4 and pathological HUTT (χ[1] = 6.392, p = 0.011). Results of the multivariate regression analysis revealed that increase in the BS is associated with the increased likelihood of HUTT pathology (Exp[B] 1.44, 95% CI 1.084–1.922, p = 0.012), while increase in age is associated with lower risk of HUTT pathology (Exp[B] 0.968, 95% CI 0.939–0.998, p = 0.036). Conclusion: There is an association between autonomic nervous system abnormalities on HUTT test and generalized joint hypermobility.

scholarly journals Involvement of Autonomic Nervous System in New-Onset Atrial Fibrillation during Acute Myocardial Infarction

2020 ◽  
Vol 9 (5) ◽  
pp. 1481 ◽  
Author(s):  
Audrey Sagnard ◽  
Charles Guenancia ◽  
Basile Mouhat ◽  
Maud Maza ◽  
Marie Fichot ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Sinus Rhythm ◽  
Left Ventricular Ejection ◽  
Holter Ecg ◽  
Autonomic Nervous ◽  
New Onset

Background: Atrial fibrillation (AF) is common after acute myocardial infarction (AMI) and associated with in-hospital and long-term mortality. However, the pathophysiology of AF in AMI is poorly understood. Heart rate variability (HRV), measured by Holter-ECG, reflects cardiovascular response to the autonomic nervous system and altered (reduced or enhanced) HRV may have a major role in the onset of AF in AMI patients. Objective: We investigated the relationship between autonomic dysregulation and new-onset AF during AMI. Methods: As part of the RICO survey, all consecutive patients hospitalized for AMI at Dijon (France) university hospital between June 2001 and November 2014 were analyzed by Holter-ECG <24 h following admission. HRV was measured using temporal and spectral analysis. Results: Among the 2040 included patients, 168 (8.2%) developed AF during AMI. Compared to the sinus-rhythm (SR) group, AF patients were older, had more frequent hypertension and lower left ventricular ejection fraction LVEF. On the Holter parameters, AF patients had higher pNN50 values (11% vs. 4%, p < 0.001) and median LH/HF ratio, a reflection of sympathovagal balance, was significantly lower in the AF group (0.88 vs 2.75 p < 0.001). The optimal LF/HF cut-off for AF prediction was 1.735. In multivariate analyses, low LF/HF <1.735 (OR(95%CI) = 3.377 (2.047–5.572)) was strongly associated with AF, ahead of age (OR(95%CI) = 1.04(1.01–1.06)), mean sinus-rhythm rate (OR(95%CI) = 1.03(1.02–1.05)) and log NT-proBNP (OR(95%CI) = 1.38(1.01–1.90). Conclusion: Our study strongly suggests that new-onset AF in AMI mainly occurs in a dysregulated autonomic nervous system, as suggested by low LF/HF, and higher PNN50 and RMSSD values.

ROLE OF AUTONOMIC NERVOUS SYSTEM AND RECURRENCE OF ATRIAL FIBRILLATION AFTER SUCCESSFUL CARDIOVERSION

2005 ◽  
Author(s):  
EIICHI WATANABE ◽  
TOMOHARU ARAKAWA ◽  
MAO QUIN TONG ◽  
TATSUSHI UCHIYAMA ◽  
ITSUO KODAMA ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Autonomic Nervous
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