scholarly journals Cardiac autonomic function and cognitive performance in patients with atrial fibrillation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
P Haemmerle ◽  
S Aeschbacher ◽  
A Springer ◽  
C Eken ◽  
M Coslovsky ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Autonomic Function ◽  
Cognitive Testing ◽  
Cardiac Autonomic Function ◽  
Multicenter Cohort Study ◽  
Funding Sources ◽  
Cardiac Autonomic Dysfunction

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Swiss National Science Foundation OnBehalf Swiss-AF Investigators Background Atrial fibrillation (AF) is associated with loss of cognition and dementia. Cardiac autonomic dysfunction has been linked to cognitive decline. We aimed to investigate if reduced cardiac autonomic function (CAF) is associated with cognitive impairment in AF patients.  Methods Patients with paroxysmal, persistent and permanent AF were enrolled from a multicenter cohort study if they presented in AF ("AF group") or in sinus rhythm ("SR group") on a baseline 5-minute ECG recording. Parameters quantifying CAF (heart rate variability triangular index (HRVI), mean heart rate (MHR), the root mean square of successive differences (RMSSD) and the standard deviation of the normal-to-normal intervals (SDNN)) were calculated. We used the Montreal Cognitive Assessment (MoCA) to assess global cognitive function. Results 1,685 AF patients with a mean age of 73 ± 8 years, 29% females, were included. The MoCA score was 24.5 ± 3.2 in the AF group (n = 710 patients) and 25.4 ± 3.2 in the SR group (n = 975 patients). After adjusting for multiple confounders, lower HRVI was associated with lower MoCA scores, both in the SR group (β=0.049; 95% confidence interval (CI): 0.016 to 0.081; p = 0.003) and in the AF group (β=0.068; 95% CI: 0.020 to 0.116; p = 0.006). In the AF group, higher MHR was associated with a poorer performance in the MoCA (β=-0.008; 95% CI: -0.014 to -0.002; p = 0.014 ). Other parameters of CAF were not associated with cognition. Conclusion Our data suggest that impaired CAF is associated with worse cognitive performance in patients with AF. Elderly AF patients with impaired HRVI might undergo cognitive testing in order to screen for cognitive impairment.

scholarly journals Cardiac autonomic function and cognitive performance in patients with atrial fibrillation

2021 ◽  
Author(s):  
Peter Hämmerle ◽  
Stefanie Aeschbacher ◽  
Anne Springer ◽  
Ceylan Eken ◽  
Michael Coslovsky ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Cognitive Performance ◽  
Autonomic Function ◽  
Convincing Evidence ◽  
Total Power ◽  
Cardiac Autonomic Function ◽  
Multicenter Cohort Study ◽  
Cardiac Autonomic Dysfunction ◽  
Moca Score

Abstract Background Atrial fibrillation (AF) is associated with loss of cognition and dementia. Cardiac autonomic dysfunction has been linked to cognitive decline. We aimed to investigate if reduced cardiac autonomic function (CAF) is associated with cognitive impairment in AF patients. Methods Patients with paroxysmal, persistent and permanent AF were enrolled from a multicenter cohort study if they had AF (“AF group”) or sinus rhythm (“SR group”) on a baseline 5 min ECG recording. Parameters quantifying CAF (heart rate variability triangular index (HRVI), mean heart rate (MHR), RMSSD, SDNN, total power and power in the VLF, LF, HF ranges) were calculated. We used the Montreal Cognitive Assessment (MoCA) to assess global cognitive function. Results 1685 AF patients with a mean age of 73 ± 8 years, 29% females, were included. MoCA score was 24.5 ± 3.2 in the AF group (N = 710 patients) and 25.4 ± 3.2 in the SR group (N = 975 patients). After adjusting for multiple confounders, lower HRVI was associated with lower MoCA scores, both in the SR group [β = 0.049; 95% confidence interval (CI) 0.016–0.081; p = 0.003] and in the AF group (β = 0.068; 95% CI 0.020–0.116; p = 0.006). In the AF group, higher MHR was associated with a poorer performance in the MoCA (β =  − 0.008; 95% CI − 0.014 to − 0.002; p = 0.014). We found no convincing evidence of association for other CAF parameters with cognition. Conclusion Our data suggest that impaired CAF is associated with worse cognitive performance in patients with AF. Among standard HRV parameters, HRVI might be the most promising ECG index. Trial registration ClinicalTrials.gov Identifier: NCT02105844. Graphic abstract

Cardiac autonomic function in panic disorder: Analysis of 24-hour heart rate time series

1995 ◽  
Vol 37 (9) ◽  
pp. 622-623
Author(s):  
V.K. Yeragani ◽  
E. Sobolewski ◽  
S. Vempati ◽  
S. Yeragani ◽  
J. Kay ◽  
...  
Keyword(s):  
Heart Rate ◽  
Time Series ◽  
Panic Disorder ◽  
Autonomic Function ◽  
Cardiac Autonomic Function

Abstract 17165: Natural History of Cardiac Function in Patients With Atrial Fibrillation Pre- and Post- Ablation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Lisa YW Tang ◽  
Kendall Ho ◽  
Nathaniel Hawkins ◽  
Roger Tam ◽  
Michael Lim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Natural History ◽  
Cardiac Function ◽  
Older Patients ◽  
Autonomic Function ◽  
Pronounced Increase ◽  
Success Group ◽  
History Of ◽  
Future Work

Intro: The natural history of cardiac function in atrial fibrillation (AF) patients undergoing pulmonary vein isolation (PVI) is incompletely described, as are heart rate patterns pre- and post-ablation. Goals: Examine autonomic status pre- and post-ablation using cardiac data (n=346) captured by implanted recorders Methods: Daily records (90-day pre to 365-day post ablation) were analyzed to extract parameters viz. heart rate variability (HRV), daytime heart rate (DHR) and nighttime heart rate (NHR). Analysis of variance was used to assess relationships between covariates (age, sex, etc.) and pre-post changes in parameters. We define "success" as patients who had no recurrence during post-ablation period per guidelines (“failed” otherwise). Results: Prior to ablation, mean DHR, NHR, and HRV were 69±10bpm, 60±9bpm, 122±32msec, respectively. After PVI, there was an immediate increase of ~5bpm in DHR (P<1e-4) and a more pronounced increase of ~11bpm in NHR (P<1e-4). HRV exhibited an immediate post-ablation peak decreasing by ~60msec (P<1e-4), with rapid recalibration over the first 10 post ablation days (increase of 20-25msec). Antiarrhythmic drug-use was a significant factor only in explaining changes in HRV (P=0.0126), while age was a significant factor only for the changes in DHR (P<1e-4). Comparing between subgroups, DHR and NHR were generally higher in the success than the failed group. At baseline, older patients (92 patients were of age>65years) had a significantly lower DHR and NHR than younger patients (117 were of age<56years). These age-based differences were amplified post ablation in DHR and NHR, but not HRV. Conclusions: PVI results in significant and sustained changes in heart rate parameters related to autonomic function. This relationship was observed globally, with the success group having significantly greater rises in DHR and NHR when compared to the failed group. Future work will explore whether these patterns exist in different cohorts.

scholarly journals Heart rate variability and long chain n-3 PUFA in patients with chronic kidney disease commencing haemodialysis: a cross-sectional study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Ana Pinto ◽  
Helen MacLaughlin ◽  
Robert Gray ◽  
Wendy Hall
Keyword(s):  
Chronic Kidney Disease ◽  
Fatty Acids ◽  
Heart Rate ◽  
Cardiac Death ◽  
Autonomic Function ◽  
Cross Sectional Study ◽  
Cardiac Autonomic Function ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Chain

AbstractThe risk of sudden cardiac death (SCD) is doubled when a patient with chronic kidney disease (CKD) stage 5 starts haemodialysis. Low heart rate variability (HRV) has been reported to be independently associated with increased risk of SCD and all cardiac death in haemodialysis patients. Long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA; 20:5n-3, EPA and 22:6n-3, DHA) may exert anti-arrhythmic effects on cardiac myocytes. Haemodialysis patients have lower serum LC n-3 PUFA levels compared to populations without CKD. Few studies have investigated the relationship between LC n-3 PUFA and HRV in patients with CKD. This study aimed to characterise the variability of LC n-3 PUFA status in patients who recently commenced haemodialysis, and to investigate relationships between LC n-3 PUFA status and HRV. A cross-sectional study was conducted in adults aged 40–80 years with CKD commencing haemodialysis (within 6–10 weeks) (NRES research ethics committee ref: 14/LO/0186). At 2 separate study days, pre-dialysis blood samples were taken to measure fatty acid composition by GC, and HRV monitors (Actiheart, CamNtech Ltd, UK) were fitted after dialysis had started to monitor parameters of cardiac autonomic function during dialysis, during the night, and for a total of 24 h. Forty-five patients (mean age 58 y, SD 9, 20 females/25 males) completed data collection at least once; 91% presented hypertension and 39% had type 2 diabetes. Sample mean omega-3 index (O3I; EPA + DHA as a % of fatty acids in erythrocyte membranes) was very low (3.45%, SD 1.25; median 3.26 %, IQR 1.32); only 2 individuals had O3I > 5%. Variability in erythrocyte EPA (median 0.66 %, IQR 0.42) and DHA (median 2.40 %, IQR 1.32) was limited. Most HRV parameters did not significantly correlate with O3I following adjustment (e.g. age, BMI, β-blockers). Plasma EPA significantly positively correlated with overall and longer phase components of HRV and significantly negatively correlated with beat-to-beat variability over 24 h after full adjustment for confounders. This suggests that although higher circulating EPA concentrations were associated with better cardiac responsivity to environmental stimulations over 24 h, they were also associated with poorer parasympathetic tone (the predominant influence on beat-to-beat HRV). No correlations were observed between plasma DHA and HRV. The divergent pattern of relationships between plasma EPA versus DHA and HRV raises the theory that patients commencing haemodialysis may have compromised conversion of EPA to DHA which may impair vagally-mediated regulation of cardiac autonomic function, a potential mechanism for high risk of SCD.

Effects of circumferential or segmental pulmonary vein ablation for paroxysmal atrial fibrillation on cardiac autonomic function

Heart Rhythm ◽  
2006 ◽  
Vol 3 (12) ◽  
pp. 1428-1435 ◽  
Author(s):  
Axel Bauer ◽  
Isabel Deisenhofer ◽  
Raphael Schneider ◽  
Bernhard Zrenner ◽  
Petra Barthel ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Paroxysmal Atrial Fibrillation ◽  
Autonomic Function ◽  
Cardiac Autonomic Function ◽  
Pulmonary Vein Ablation

Heart Rate Variability, Mortality, and Exercise in Patients with End-Stage Renal Disease

2000 ◽  
Vol 10 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Ann K. Cashion ◽  
Patricia A. Cowan ◽  
E. Jean Milstead ◽  
A. Osama Gaber ◽  
Donna K. Hathaway
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Kidney Transplantation ◽  
Renal Disease ◽  
Mortality Risk ◽  
End Stage Renal Disease ◽  
Autonomic Function ◽  
Cardiac Autonomic Function ◽  
Stage Renal Disease ◽  
End Stage

Context Cardiac autonomic function has been associated with mortality in patients with end-stage renal disease. It is unknown whether end-stage renal disease patients who have succumbed to sudden cardiac death can be better identified by a newer test of heart rate variability that uses spectral analysis, rather than laboratory evoked measures. Objective This series of studies sought to characterize cardiac autonomic function in patients awaiting kidney transplantation, identify factors associated with heart rate variability, identify tests which distinguish patients at-risk for death, and compare evoked measures with 24-hour heart rate variability measures. Patients Data were collected on 184 nondiabetics, 60 type 1 diabetics, and 34 type 2 diabetics with end-stage renal disease, all of whom had been referred for kidney transplantation. Main Outcome Measures The 278 patients and 67 healthy control subjects underwent evoked tests (changes in heart rate with deep breathing and Valsalva maneuver) and 24-hour heart rate variability Holter monitoring (time and frequency domains). Five patients had sudden cardiac deaths during the study. Results Data showed that end-stage renal disease patients, particularly diabetics, had compromised autonomic function. The standard deviation of all R-to-R intervals for the electrocardiogram recording (<50 minutes in 60% of the deceased patients), a 24-hour heart rate variability time domain measure, holds the promise of identifying patients at increased risk for death. Exercise was identified as a factor associated with better autonomic function. Examining relationships between 24-hour heart rate variability and characteristics of patients who succumb to death could make quantification of the mortality risk for individual pretransplant end-stage renal disease patients possible, much as it has in other populations. The data from this study may also make it possible to design interventions, such as exercise, aimed at reducing mortality risk.

scholarly journals Effects of Daily Intake of Almonds on Cardiac Autonomic Functions Measured by Heart Rate Variability in Response to Acute Stress: A Randomized Controlled Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 20-20
Author(s):  
Vita Dikariyanto ◽  
Leanne Smith ◽  
May Robertson ◽  
Eslem Kusaslan ◽  
Molly O'Callaghan-Latham ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Mental Stress ◽  
Autonomic Function ◽  
Acute Stress ◽  
Physical Stress ◽  
Cardiometabolic Health ◽  
Cardiac Autonomic Function ◽  
Randomized Controlled

Abstract Objectives Stress is inversely associated with heart rate variability (HRV), an indicator of cardiac autonomic function and a predictor of risk of sudden cardiac death. At times of stress, people tend to favor high sugar and fatty foods, often as snacks, with potential adverse effects on cardiometabolic health. Dietary recommendations for cardiovascular disease (CVD) prevention emphasize fruits, vegetables, wholegrains and nuts. There is evidence that consumption of nuts can reduce LDL cholesterol and blood pressure and help with weight management, however the impact of nuts on HRV in response to stress is unknown. The ATTIS dietary intervention study investigated the HRV response to acute stress following 6-week substitution of almonds for typical snacks high in refined starch, free sugars and saturated fats, and low in fibre. The study population comprised adults aged 30–70 y, who were habitual snack consumers, and at moderate risk of developing CVD. It was hypothesized that snacking on almonds would increase HRV during stress tasks, when HRV is expected to be reduced due to increased sympathetic activity. Methods A 6-week randomized controlled parallel trial was conducted. Participants were randomized to 1) control snacks (mini-muffins formulated to follow the average UK snack nutrient profile), or 2) dry-roasted whole almonds, both providing 20% estimated energy requirement. Supine HRV was measured (Mega Electronics Emotion Faros 180°, 2-leads wearable ECG-HRV monitor) during resting (5 min), physical stress (blood pressure monitor cuff inflation 200 mmHg, 5 min) and mental stress (Stroop colour-word test, 5 min) tasks pre- and post-intervention. A total of 105 participants (73 females and 32 males; mean age 56.2 y, SD 10.4) completed the trial. Results Almonds significantly increased the beat-to-beat HRV parameter, high-frequency power, during the mental stress test (mean difference 124 ms2; 95% CI 11, 237; P = 0.031) relative to control, indicating increased parasympathetic regulation. There were no treatment effects during resting and the physical stress task. Conclusions Snacking on whole almonds as a replacement for typical snacks increases HRV during mental stress, indicating an increased resilience in cardiac autonomic function and a novel mechanism whereby nuts may be cardioprotective. Funding Sources Almond Board of California.

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