scholarly journals Association of autonomic dysfunction and clozapine

2001 ◽  
Vol 179 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Hagit Cohen ◽  
Uri Loewenthal ◽  
Michael Matar ◽  
Moshe Kotler

BackgroundAntipsychotic medications cause a wide range of adverse effects and have been associated with sudden death in psychiatric patients.AimsTo supply power spectral analysis of heart rate variability as a tool to examine the arrythmogenic effects of neuroleptics.MethodHeart rate analysis was carried out in patients with schizophrenia on standard doses of neuroleptic monotherapy − 21 were on clozapine, 18 on haloperidol and 17 on olanzapine – and in 53 healthy subjects.ResultsPatients with schizophrenia on clozapine had significantly higher heart rate, lower heart rate variability and lower high-frequency and higher low-frequency components compared with patients on haloperidol or olanzapine and matched control subjects. Prolonged QTc intervals were more common in patients than controls.ConclusionsPatients treated with neuroleptic medications, especially clozapine, showed autonomic dysregulation and cardiac repolarisation changes. Physicians should be aware of this adverse reaction.

2013 ◽  
Vol 305 (2) ◽  
pp. R164-R170 ◽  
Author(s):  
D. Xu ◽  
J. K. Shoemaker ◽  
A. P. Blaber ◽  
P. Arbeille ◽  
K. Fraser ◽  
...  

Limited data are available to describe the regulation of heart rate (HR) during sleep in spaceflight. Sleep provides a stable supine baseline during preflight Earth recordings for comparison of heart rate variability (HRV) over a wide range of frequencies using both linear, complexity, and fractal indicators. The current study investigated the effect of long-duration spaceflight on HR and HRV during sleep in seven astronauts aboard the International Space Station up to 6 mo. Measurements included electrocardiographic waveforms from Holter monitors and simultaneous movement records from accelerometers before, during, and after the flights. HR was unchanged inflight and elevated postflight [59.6 ± 8.9 beats per minute (bpm) compared with preflight 53.3 ± 7.3 bpm; P < 0.01]. Compared with preflight data, HRV indicators from both time domain and power spectral analysis methods were diminished inflight from ultralow to high frequencies and partially recovered to preflight levels after landing. During inflight and at postflight, complexity and fractal properties of HR were not different from preflight properties. Slow fluctuations (<0.04 Hz) in HR presented moderate correlations with movements during sleep, partially accounting for the reduction in HRV. In summary, substantial reduction in HRV was observed with linear, but not with complexity and fractal, methods of analysis. These results suggest that periodic elements that influence regulation of HR through reflex mechanisms are altered during sleep in spaceflight but that underlying system complexity and fractal dynamics were not altered.


1998 ◽  
Vol 275 (1) ◽  
pp. H213-H219 ◽  
Author(s):  
Michael V. Højgaard ◽  
Niels-Henrik Holstein-Rathlou ◽  
Erik Agner ◽  
Jørgen K. Kanters

Frequency domain analysis of heart rate variability (HRV) has been proposed as a semiquantitative method for assessing activities in the autonomic nervous system. We examined whether absolute powers, normalized powers, and the low frequency-to-high frequency ratio (LF/HF) derived from the HRV power spectrum could detect shifts in autonomic balance in a setting with low sympathetic nervous tone. Healthy subjects were examined for 3 h in the supine position during 1) control conditions ( n = 12), 2) acute β-blockade ( n = 11), and 3) chronic β-blockade ( n = 10). Heart rate fell during the first 40 min of the control session (72 ± 2 to 64 ± 2 beats/min; P < 0.005) and was even lower during acute and chronic β-blockade (56 ± 2 beats/min; P < 0.005). The powers of all spectral areas rose during the first 60 min in all three settings, more so with β-blockade ( P < 0.05). LF/HF was found to contain the same information as powers expressed in normalized units. LF/HF detected the shift in autonomic balance induced by β-blockade but not the change induced by supine position. In conclusion, none of the investigated measures derived from power spectral analysis comprehensively and consistently described the changes in autonomic balance.


1995 ◽  
Vol 268 (6) ◽  
pp. H2239-H2245 ◽  
Author(s):  
D. R. Grimm ◽  
R. E. DeMeersman ◽  
R. P. Garofano ◽  
A. M. Spungen ◽  
W. A. Bauman

This study investigated heart rate variability (HRV) in individuals with quadriplegia who have disruption of autonomic control of the heart. Seven male subjects with neurological complete quadriplegia and seven with incomplete quadriplegia were studied at rest and during provocation. HRV was measured by power spectral analysis using a fast Fourier transform. Two spectral components were generated: 1) the high-frequency (HF) peak, a reflection of parasympathetic activity, and 2) the low-frequency (LF) peak, primarily sympathetic activity with some parasympathetic input. Results of the provocative maneuvers were grouped into one composite variable. Significant differences in the LF spectral component were found between the groups with complete and incomplete lesions in the supine position and after provocation (LF supine: P = 0.01; LF provocation: P = 0.002). After provocation, significant differences were demonstrated in the HF spectral component between these groups (P = 0.005). In contrast to previous findings, a LF component in subjects with complete quadriplegia was observed; this LF component decreased after provocation, suggesting the parasympathetic component withdrew during stressful maneuvers. There also appeared to be general downregulation of parasympathetic activity to the heart in subjects with complete quadriplegia. The presence of an increased LF spectral component during provocation in those with incomplete lesions implies sympathetic stimulation of the heart and may be used as a marker of sympathetic activity in individuals with quadriplegia.


2016 ◽  
Vol 43 (3) ◽  
pp. 146-150
Author(s):  
Qazi Farzana Akhter ◽  
Qazi Shamima Akhter ◽  
Farhana Rahman ◽  
Sybilla Ferdousi ◽  
Susmita Sinha

Heart rate variability (HRV) has been considered as an indicator of autonomic nerve function status. We aimed to find out the reference values of heart rate variability by power spectral analysis in our healthy population of both sex. This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from the period of July 2012 to June 2013. For this, 180 subjects were selected with the age ranging from 15-60 years. All the study subjects were divided into 3 different groups according to age (Group A: 15-30 years; Group B: 31-45 years; Group C: 46-60 years). Each group contained 60 subjects of which 30 were male and 30 were female. Analysis of HRV parameters were done in Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Systolic blood pressure, diastolic blood pressure, low frequency normalized unit, low frequency / high frequency ratio were significantly higher in male than female. Again high frequency power, high frequency normalized unit were significantly higher in female than male of same age group. This study concludes that male showed higher cardiac sympathetic activities while female showed higher cardiac parasympathetic activities in different age groups.Bangladesh Med J. 2014 Sep; 43 (3): 146-150


2007 ◽  
Vol 25 (11) ◽  
pp. 2280-2285 ◽  
Author(s):  
Robert H Fagard ◽  
Katarzyna Stolarz ◽  
Tatiana Kuznetsova ◽  
Jitka Seidlerova ◽  
Valérie Tikhonoff ◽  
...  

2012 ◽  
Vol 15 (3) ◽  
pp. 264-272 ◽  
Author(s):  
Keiko Tanida ◽  
Masashi Shibata ◽  
Margaret M. Heitkemper

Clinical researchers do not typically assess sleep with polysomnography (PSG) but rather with observation. However, methods relying on observation have limited reliability and are not suitable for assessing sleep depth and cycles. The purpose of this methodological study was to compare a sleep analysis method based on power spectral indices of heart rate variability (HRV) data to PSG. PSG and electrocardiography data were collected synchronously from 10 healthy women (ages 20–61 years) over 23 nights in a laboratory setting. HRV was analyzed for each 60-s epoch and calculated at 3 frequency band powers (very low frequency [VLF]-hi: 0.016–0.04 Hz; low frequency [LF]: 0.04–0.15 Hz; and high frequency [HF]: 0.15–0.4 Hz). Using HF/(VLF-hi + LF + HF) value, VLF-hi, and heart rate (HR) as indices, an algorithm to categorize sleep into 3 states (shallow sleep corresponding to Stages 1 & 2, deep sleep corresponding to Stages 3 & 4, and rapid eye movement [REM] sleep) was created. Movement epochs and time of sleep onset and wake-up were determined using VLF-hi and HR. The minute-by-minute agreement rate with the sleep stages as identified by PSG and HRV data ranged from 32 to 72% with an average of 56%. Longer wake after sleep onset (WASO) resulted in lower agreement rates. The mean differences between the 2 methods were 2 min for the time of sleep onset and 6 min for the time of wake-up. These results indicate that distinguishing WASO from shallow sleep segments is difficult using this HRV method. The algorithm's usefulness is thus limited in its current form, and it requires additional modification.


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