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Clinical Research in Cardiology 05/2013; · 2.95 Impact Factor
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International journal of cardiology 11/2012; · 7.08 Impact Factor
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ABSTRACT: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia observed in clinical practice. It is characterized
by chaotic electrical activity in the atria with consequent loss of atrial mechanical function and irregular induction of
ventricular contraction. AF adversely affects quality of life and causes considerable mortality and morbidity, particularly
from heart failure, stroke, and brady- or tachyarrhythmia. Its incidence and prevalence increases in the aging population,
rising from 0.1% in subjects under 55years up to 9% among patients older than 80years. Consequently, the public health burden
associated with AF is increasing, reflecting the aging population. Present studies have shown atrial fibrillation as a powerful
contributor to increased mortality and medical cost. Despite improvement in our understanding of the advantages and inconveniencies
of rate and rhythm control strategies, current therapeutic options, like anticoagulant and antiarrhythmic therapy, only prevent
a part of this burden. This article provides a brief overview of the patients and physicians, such as epidemiologic and socioeconomic
burden.
KeywordsAtrial fibrillation–Arrhythmia–Morbidity–Quality of life–Aging
Clinical Research in Cardiology Supplements 04/2012; 5:57-62.
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ABSTRACT: The aim of the present study was to assess potential differences in cardiac autonomic nervous modulation in patients with transient left ventricular apical ballooning syndrome (AB) and the midventricular variant (MB) of this syndrome.
We hypothesized that differences in regional distribution of cardiac autonomic innervation in AB and MB may induce alterations in autonomic modulation, and we tested this assumption by using a combination of traditional and novel nonlinear parameters of heart rate variability (HRV).
In a prospective single-center study, 49 consecutive patients with transient left ventricular dysfunction syndrome underwent Holter electrocardiographic recording on the third day after admission. A total of 27 recordings of patients with AB and 10 recordings of patients with MB were valid for analysis of HRV, nonlinear dynamic measures of HRV, detrended fluctuation analysis (DFA), and phase-rectified signal averaging (PRSA).
There were no significant differences in baseline clinical characteristics between AB and MB patients. Patients with MB showed significantly lower values for mean RR interval (835 ± 104 ms vs. 908 ± 118 ms; P < .05), 1/f power law slope (-1.28 ± 0.2 vs. -1.13 ± 0.2; P < .01), and deceleration capacity (DC) (4.6 ± 1.4 ms vs. 6.0 ± 1.4 ms; P < .01), and significantly higher values for low-frequency (LF) spectral component (5.3 ± 0.5 ln ms(2)/Hz vs. 4.8 ± 0.5 ln ms(2)/Hz), LF/high-frequency (HF) (1.7 ± 0.9 ms vs. 1.3 ± 0.6 ms; P < .05), and DFA α1 (1.09 ± 0.1 vs. 0.99 ± 0.1; P < .01) than patients with AB. There were no significant correlations between parameters of HRV, DFA, 1/f power law slope, and PRSA.
There are significant differences in heart rate dynamics between AB and MB syndromes. Patients with MB show stronger fractal correlations of heart rate dynamics. Thus, inhomogeneous efferent bilateral sympathetic coactivation and differences in reflex autonomic regulation may be underlying pathophysiological mechanisms for AB and MB syndromes.
Heart rhythm: the official journal of the Heart Rhythm Society 12/2010; 7(12):1825-32. · 4.56 Impact Factor
