STUDY OF HEART RATE VARIABILITY IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION DURING PROPHYLACTIC TREATMENT OF METOPROLOL AND CORDARONE FOR ONE YEAR

2021 ◽  
pp. 128-135
Author(s):  
Rybakova T.A. ◽  
Stolyarova V.V. ◽  
Gizova M.V.
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Paroxysmal Atrial Fibrillation ◽  
Antiarrhythmic Drugs ◽  
Antiarrhythmic Therapy ◽  
Healthy Individuals ◽  
Initial Stage ◽  
One Year ◽  
Permanent Form

This work is devoted to the dynamic study of heart rate variability indicators for one year in patients with paroxysmal atrial fibrillation treated with antiarrhythmic drugs metoprolol and cordarone. The study found that patients treated with metoprolol monotherapy had a weakening of parasympathetic effects on the heart, due to a decrease in Mean by 12.9%, Mo by 13%, Amo by 29.4%, SDNN by 28.3% compared to the group of healthy individuals, but they differed in stable indicators of heart rate variability and 33% retained sinus rhythm during the year. With cordarone monotherapy, there was a curative effect of sympathetic and parasympathetic effects on the heart, as indicated by an increase in: Mean by 15.9%, Mo by 15.9%, IVR by 95.5%, Amo by 41.1% and a decrease in SDNN by 37.5%, compared with the group of healthy individuals at the initial stage. A year later, a negative dynamics was revealed - the predominance of sympathetic influences on the heart compared to the groups of healthy individuals and the control due to an increase in: IVR by 363.3% and 238.5%; VPR by 116.7% and 106%; Amo by 111.2% and 72.9; IN by 304% and 246.8%; PAPR by 92% and 79.1%, respectively. During the year, 39% of patients left the study due to the replacement of antiarrhythmic therapy and 16.5% due to the development of a permanent form of atrial fibrillation. In the remaining patients in the study, in comparison with their initial data, there was a predominance of sympathetic effects on the heart due to an increase in IVR by 137%. In combination therapy with metoprolol and cordarone, there were no significant changes in heart rate variability compared to the initial ones. Initially, there was a decrease in overall heart rate variability due to a decrease in SDNN by 28.4% and a decrease in parasympathetic effects on the heart due to an increase in Amo by 45.2% and a decrease in Delta X by 32.9% compared to the group of healthy individuals. After a year, 40% left the study due to the replacement of antiarrhythmic therapy and 30% due to the development of a permanent form of atrial fibrillation. During dynamic observation of patients, it was found that the following indicators have the most important prognostic value in the development of atrial fibrillation: SDNN, Delta X and RMSSD. Therefore, it is very important to register an ECG with the measurement of these indicators at least once every 3 months for timely correction of treatment.

scholarly journals Cryoballoon Versus High-Power, Short-Duration Radiofrequency Ablation for Pulmonary Vein Isolation in Patients With Paroxysmal Atrial Fibrillation

2021 ◽  
Vol 14 (9) ◽  
Author(s):  
Hui-Nam Pak ◽  
Je-Wook Park ◽  
Song-Yi Yang ◽  
Tae-Hoon Kim ◽  
Jae-Sun Uhm ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
High Power ◽  
Paroxysmal Atrial Fibrillation ◽  
Antiarrhythmic Drugs ◽  
Procedure Time

Background: The efficacy of cryoballoon pulmonary vein isolation (Cryo-PVI) is equivalent to that of radiofrequency pulmonary vein isolation in patients with paroxysmal atrial fibrillation (AF). We aimed to compare the efficacy and safety profile of Cryo-PVI and high-power, short-duration (HPSD) radiofrequency catheter ablation (RFCA) in patients with AF. Methods: We prospectively randomized 314 patients with paroxysmal AF (men, 71.3%; 59.9±10.9 years old) to either the Cryo-PVI group (n=156) or HPSD-RFCA group (n=158). Cavotricuspid isthmus ablation and linear ablation from the superior vena cava to the right atrial septum in addition to pulmonary vein isolation were carried out in the majority of patients in the HPSD-RFCA group. The primary end point was AF recurrence after a single procedure; secondary end points were the recurrence pattern, cardioversion rate, follow-up heart rate variability, and response to antiarrhythmic drugs. Results: After a mean follow-up of 9.8±5.1 months, the clinical recurrence rate did not significantly differ between the two groups (log-rank P =0.840). The rate of recurrence as atrial tachycardia ( P >0.999), cardioversion ( P =0.999), and 3-month heart rate variability (high frequency; P =0.506) did not significantly differ. During the final follow-up, sinus rhythm was maintained without antiarrhythmic drugs in 70.5% of the Cryo-PVI group and 73.4% of the HPSD-RFCA group ( P =0.567). No significant difference was found in the major complication rate between the two groups (3.8% versus 0.6%; P =0.066), but total procedure time was significantly shorter in the Cryo-PVI group (78.5±20.2 versus 124.5±37.1 minutes; P <0.001). Conclusions: In patients with paroxysmal AF, the Cryo-PVI is an effective rhythm-control strategy with a shorter procedure time compared with the HPSD-RFCA. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03920917.

scholarly journals ANALYSIS OF THE RESULTS OF FIVE YEAR PATIENTS FOLLOW-UP IN PAROXYSMAL ATRIAL FIBRILLATION TREATED WITH ANTIARRHYTHMICS

2018 ◽  
pp. 67-72
Author(s):  
T. A. Rybakova ◽  
V. V. Stolyarova ◽  
M. G. Nazarkina ◽  
N. Yu. Leschankina
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Sinus Rhythm ◽  
Paroxysmal Atrial Fibrillation ◽  
Antiarrhythmic Therapy

Aim.To analyze the results of 5-year follow-up of the paroxysmal atrial fibrillation patients (PAF) taking antiarrhythmic therapy (AAT)Material and methods.Patients (n=500) were selected to 11 groups: I — healthy, II — controls, III-XI — PAF taking AAT. The baseline parameters of heart rate variability (HRV) were assessed during 5-year follow-up.Results.Decrease of SDNN does 1,9 times increase the risk of AF development during the first 3 months from preventive AAT start. Decrease of RMSSD does 3,9 times increase the risk of AF during the first 2 weeks, and 1,9 times — 3 months; decrease of Delta X increases the risk of AF 3,9 times during 2 weeks, 2 times — during 3 months, 1,4 times — during 6 months, 1,3 times — during 12 months and 3 years. Increase of Amo does 1,8 times increase the risk of AF during first 3 months. If there was baseline decrease of Delta X and RMSSD, then within 2 weeks the AF paroxysm developed in 7,9% patients, and in 3 months — 15,9% patients. With the decrease of Delta X and RMSSD, in combination with low SDNN, the probability of sinus rhythm retention during 1 year is 51,2%.Conclusion.PAF patients taking preventive AAT demand for ECG assessment of HRV parameters no less than once per 3 months.

scholarly journals P095 Heart Rate Variability during Sleep in Paroxysmal Atrial Fibrillation patients with and without Obstructive Sleep Apnoea

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A52-A52
Author(s):  
A Mohammadieh ◽  
H Dissanayake ◽  
K Sutherland ◽  
S Ucak ◽  
P de Chazal ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Obstructive Sleep Apnoea ◽  
Paroxysmal Atrial Fibrillation ◽  
Sleep Apnoea ◽  
Relative Reduction ◽  
Obstructive Sleep ◽  
Sympathetic Modulation ◽  
Ectopic Beats

Abstract Introduction Physiological studies have demonstrated the importance of the autonomic nervous system in mediating acute apnoea-induced atrial fibrillation (AF). We aimed to compare Heart Rate Variability (HRV) markers of autonomic function in paroxysmal atrial fibrillation (PAF) patients with and without obstructive sleep apnoea (OSA). A secondary aim was the analysis of ectopic beats in these groups. Methods Nocturnal ECG traces from 89 PAF patients who underwent in-laboratory polysomnography were included. After identifying ectopic beats in the ECGs, periods of arrhythmia as well as sleep apnoea events were excluded. HRV time and frequency domains were reported by sleep stage (REM vs Non-REM) for patients with and without OSA. Results Frequency domain analysis of HRV during non-REM sleep in PAF patients with OSA showed increased cardiac parasympathetic modulation (HF-nu: 39.13 ± 15.74 vs 47.98 ± 14.60, p = 0.008*) and reduced cardiac sympathetic modulation (LF/HF ratio: 2.05 ± 2.02 vs 1.17 ± 0.98, p = 0.007*). Results remained significant after adjusting for age, sex and BMI (adjusted p values 0.024 and 0.018 respectively). PAF patients with severe OSA (AHI ≥ 30/hr) had more AF beats and Ventricular Ectopic Beats than those without severe OSA (22.7 ± 42.8% vs 3.7 ± 17.9%, p = 0.006*, 1.7 ± 3.8 vs 0.3 ± 0.9%, p = 0.004* respectively). Conclusions This is the first study of HRV in AF patients with and without OSA. It suggests a chronic increase in parasympathetic nervous modulation and relative reduction in sympathetic modulation in PAF patients with OSA.

scholarly journals Denervation as a Common Mechanism Underlying Different Pulmonary Vein Isolation Strategies for Paroxysmal Atrial Fibrillation: Evidenced by Heart Rate Variability after Ablation

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Kejing Wang ◽  
Dong Chang ◽  
Zhenliang Chu ◽  
Yanzong Yang ◽  
Lianjun Gao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Pulmonary Vein ◽  
Paroxysmal Atrial Fibrillation ◽  
Multivariate Logistic Regression Analysis ◽  
Common Mechanism ◽  
Success Rates ◽  
Before And After

Backgrounds. Segmental and circumferential pulmonary vein isolations (SPVI and CPVI) have been demonstrated to be effective therapies for paroxysmal atrial fibrillation (PAF). PVI is well established as the endpoint of different ablation techniques, whereas it may not completely account for the long-term success.Methods. 181 drug-refractory symptomatic PAF patients were referred for segmental or circumferential PVI (SPVI = 67; CPVI = 114). Heart rate variability (HRV) was assessed before and after the final ablation.Results. After following up for62.23±12.75months, patients underwent1.41±0.68procedures in average, and the success rates in SPVI and CPVI groups were comparable. 119 patients were free from AF recurrence (SPVI-S,n=43; CPVI-S,n=76). 56 patients had recurrent episodes (SPVI-R,n=21; CPVI-R,n=35). Either ablation technique decreased HRV significantly. Postablation SDNN and rMSSD were significantly lower in SPVI-S and CPVI-S subgroups than in SPVI-R and CPVI-R subgroups (SPVI-S versus SPVI-R: SDNN91.8±32.6versus111.5±36.2 ms, rMSSD47.4±32.3versus55.2±35.2 ms; CPVI-S versus CPVI-R: SDNN83.0±35.6versus101.0±40.7 ms, rMSSD41.1±22.9versus59.2±44.8 ms; allP<0.05). Attenuation of SDNN and rMSSD remained for 12 months in SPVI-S and CPVI-S subgroups, whereas it recovered earlier in SPVI-R and CPVI-R subgroups. Multivariate logistic regression analysis identified SDNN as the only predictor of long-term success.Conclusions. Beyond PVI, denervation may be a common mechanism underlying different ablation strategies for PAF.

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