Sinus rhythm heart rate increase after atrial fibrillation ablation is associated with lower risk of arrhythmia recurrence

Abstract Background Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) allows sophisticated quantification of left atrial (LA) blood flow, and could yield novel biomarkers of propensity for intra-cardiac thrombus formation and embolic stroke. As reproducibility is critically important to diagnostic performance, we systematically investigated technical and temporal variation of LA 4D flow in atrial fibrillation (AF) and sinus rhythm (SR). Methods Eighty-six subjects (SR, n = 64; AF, n = 22) with wide-ranging stroke risk (CHA2DS2VASc 0–6) underwent LA 4D flow assessment of peak and mean velocity, vorticity, vortex volume, and stasis. Eighty-five (99%) underwent a second acquisition within the same session, and 74 (86%) also returned at 30 (27–35) days for an interval scan. We assessed variability attributable to manual contouring (intra- and inter-observer), and subject repositioning and reacquisition of data, both within the same session (same-day scan–rescan), and over time (interval scan). Within-subject coefficients of variation (CV) and bootstrapped 95% CIs were calculated and compared. Results Same-day scan–rescan CVs were 6% for peak velocity, 5% for mean velocity, 7% for vorticity, 9% for vortex volume, and 10% for stasis, and were similar between SR and AF subjects (all p > 0.05). Interval-scan variability was similar to same-day scan–rescan variability for peak velocity, vorticity, and vortex volume (all p > 0.05), and higher for stasis and mean velocity (interval scan CVs of 14% and 8%, respectively, both p < 0.05). Longitudinal changes in heart rate and blood pressure at the interval scan in the same subjects were associated with significantly higher variability for LA stasis (p = 0.024), but not for the remaining flow parameters (all p > 0.05). SR subjects showed significantly greater interval-scan variability than AF patients for mean velocity, vortex volume, and stasis (all p < 0.05), but not peak velocity or vorticity (both p > 0.05). Conclusions LA peak velocity and vorticity are the most reproducible and temporally stable novel LA 4D flow biomarkers, and are robust to changes in heart rate, blood pressure, and differences in heart rhythm.

Download Full-text

Effect of muscle mass and intensity of isometric contraction on heart rate

Journal of Applied Physiology ◽

10.1152/jappl.2000.88.2.487 ◽

2000 ◽

Vol 88 (2) ◽

pp. 487-492 ◽

Cited By ~ 17

Author(s):

José M. Gálvez ◽

Juan P. Alonso ◽

Luis A. Sangrador ◽

Gonzalo Navarro

Keyword(s):

Heart Rate ◽

Muscle Mass ◽

Rate Increase ◽

Isometric Exercise ◽

Heart Rate Increase ◽

Maximal Force ◽

Wheel Turn ◽

Obese Subjects ◽

Energetic Expenditure ◽

Handgrip Contractions

The purpose of this study was to determine the effect of muscle mass and the level of force on the contraction-induced rise in heart rate. We conducted an experimental study in a sample of 28 healthy men between 20 and 30 yr of age (power: 95%, α: 5%). Smokers, obese subjects, and those who performed regular physical activity over a certain amount of energetic expenditure were excluded from the study. The participants exerted two types of isometric contractions: handgrip and turning a 40-cm-diameter wheel. Both were sustained to exhaustion at 20 and 50% of maximal force. Twenty-five subjects finished the experiment. Heart rate increased a mean of 15.1 beats/min [95% confidence interval (CI): 5.5–24.6] from 20 to 50% handgrip contractions, and 20.7 beats/min (95% CI: 11.9–29.5) from 20 to 50% wheel-turn contractions. Heart rate also increased a mean of 13.3 beats/min (95% CI: 10.4–16.1) from handgrip to wheel-turn contractions at 20% maximal force, and 18.9 beats/min (95% CI: 9.8–28.0) from handgrip to wheel-turn contractions at 50% maximal force. We conclude that the magnitude of the heart rate increase during isometric exercise is related to the intensity of the contraction and the mass of the contracted muscle.

Download Full-text

Monitoring athletic training status using the maximal rate of heart rate increase

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2015.07.006 ◽

2016 ◽

Vol 19 (7) ◽

pp. 590-595 ◽

Cited By ~ 14

Author(s):

Clint R. Bellenger ◽

Rebecca L. Thomson ◽

Peter R.C. Howe ◽

Laura Karavirta ◽

Jonathan D. Buckley

Keyword(s):

Heart Rate ◽

Athletic Training ◽

Rate Increase ◽

Training Status ◽

Maximal Rate ◽

Heart Rate Increase

Download Full-text

Prediction of maintenance of sinus rhythm using heart rate variability characteristics after conversion in patients with atrial fibrillation

Computers in Cardiology, 2005 ◽

10.1109/cic.2005.1588038 ◽

2005 ◽

Author(s):

G. Varoneckas ◽

A. Martinkenas ◽

R. Paskeviciute ◽

A. Podlipskyte ◽

D. Zemaityte

Keyword(s):

Atrial Fibrillation ◽

Heart Rate ◽

Heart Rate Variability ◽

Sinus Rhythm

Download Full-text

Movement-induced heart rate changes in epileptic and non-epileptic seizures

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000500001 ◽

2009 ◽

Vol 67 (3b) ◽

pp. 789-791 ◽

Cited By ~ 6

Author(s):

Gisele R. de Oliveira ◽

Francisco de A.A. Gondim ◽

Edward R. Hogan ◽

Francisco H. Rola

Keyword(s):

Heart Rate ◽

Motor Activity ◽

Rate Increase ◽

Epileptic Seizures ◽

Baseline Heart Rate ◽

Heart Rate Increase ◽

Event Duration ◽

Rate Analysis ◽

Heart Rate Analysis ◽

Video Eeg

Heart rate changes are common in epileptic and non-epileptic seizures. Previous studies have not adequately assessed the contribution of motor activity on these changes nor have evaluated them during prolonged monitoring. We retrospectively evaluated 143 seizures and auras from 76 patients admitted for video EEG monitoring. The events were classified according to the degree of ictal motor activity (severe, moderate and mild/absent) in: severe epileptic (SE, N=17), severe non-epileptic (SNE, N=6), moderate epileptic (ME, N=28), moderate non-epileptic (MNE, N=11), mild epileptic (mE, N=35), mild non-epileptic (mNE, N=33) and mild aura (aura, N=13). Heart rate increased in the ictal period in severe epileptic, severe non-epileptic, moderate epileptic and mild epileptic events (p<0.05). Heart rate returned to baseline levels during the post ictal phase in severe non-epileptic seizures but not in severe epileptic patients. Aura events had a higher baseline heart rate. A cut-off of 20% heart rate increase may distinguish moderate epileptic and mild epileptic events lasting more than 30 seconds. In epileptic seizures with mild/absent motor activity, the magnitude of heart rate increase is proportional to the event duration. Heart rate analysis in seizures with different degrees of movement during the ictal phase can help to distinguish epileptic from non-epileptic events.

Download Full-text