Circadian variation of variability and irregularity of heart rate in patients with permanent atrial fibrillation: Relation to symptoms and rate-control drugs.
(2015) In American Journal of Physiology: Heart and Circulatory Physiology 309(12). p.2152-2157- Abstract
- The aim of this study is to evaluate the diurnal variation of the variability and irregularity of the heart rate (HR) in patients with permanent atrial fibrillation (AF), with and without rate-control drugs. Thirty-eight patients with permanent AF were part of an investigator-blind cross-over study, comparing diltiazem, verapamil, metoprolol, and carvedilol. We analyzed five Holter recordings per patient: at baseline (no rate-control drug) and with each of the four drug regimens. HR, variability (standard deviation, pNN20, pNN50, pNN80, and rMSSD) and irregularity (approximate (APEn) and sample entropy) parameters were computed in 20-minute long non-overlapping segments. Circadian rhythmicity was evaluated using the cosinor analysis to... (More)
- The aim of this study is to evaluate the diurnal variation of the variability and irregularity of the heart rate (HR) in patients with permanent atrial fibrillation (AF), with and without rate-control drugs. Thirty-eight patients with permanent AF were part of an investigator-blind cross-over study, comparing diltiazem, verapamil, metoprolol, and carvedilol. We analyzed five Holter recordings per patient: at baseline (no rate-control drug) and with each of the four drug regimens. HR, variability (standard deviation, pNN20, pNN50, pNN80, and rMSSD) and irregularity (approximate (APEn) and sample entropy) parameters were computed in 20-minute long non-overlapping segments. Circadian rhythmicity was evaluated using the cosinor analysis to each parameter series, that is characterized by the 24-h mean (MESOR) and the excursion over the mean (the amplitude). Arrhythmia-related symptoms were assessed by a questionnaire measuring symptoms severity (SS) and frequency (SF). HR and variability parameters showed a significant circadian variation in most patients, whereas only a small minority of the patients had circadian variation of irregularity parameters. The patients with circadian ApEn at baseline had more severe symptoms (SS = 9±4 vs. 6±5, p<0.05; circadian vs. non-circadian variation). All drugs decreased the MESOR of HR and increased the MESOR of variability parameters. Only carvedilol and metoprolol decreased the normalized amplitude over the 24-h of all parameters and HR. In conclusion, HR and RR variability parameters present a circadian variation in patients with permanent AF, whereas few patients demonstrated circadian fluctuations in irregularity parameters, suggesting different physiological mechanisms. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/8148468
- author
- Corino, Valentina D A ; Platonov, Pyotr LU ; Enger, Steve ; Tveit, Arnljot and Ulimoen, Sara R
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- in
- American Journal of Physiology: Heart and Circulatory Physiology
- volume
- 309
- issue
- 12
- pages
- 2152 - 2157
- publisher
- American Physiological Society
- external identifiers
-
- pmid:26497961
- wos:000367288700017
- scopus:84949883369
- pmid:26497961
- ISSN
- 1522-1539
- DOI
- 10.1152/ajpheart.00300.2015
- language
- English
- LU publication?
- yes
- id
- 3fa5b3ef-5950-4542-90f8-19a0aee8c00e (old id 8148468)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/26497961?dopt=Abstract
- date added to LUP
- 2016-04-01 10:06:22
- date last changed
- 2022-03-12 02:11:03
@article{3fa5b3ef-5950-4542-90f8-19a0aee8c00e,
abstract = {{The aim of this study is to evaluate the diurnal variation of the variability and irregularity of the heart rate (HR) in patients with permanent atrial fibrillation (AF), with and without rate-control drugs. Thirty-eight patients with permanent AF were part of an investigator-blind cross-over study, comparing diltiazem, verapamil, metoprolol, and carvedilol. We analyzed five Holter recordings per patient: at baseline (no rate-control drug) and with each of the four drug regimens. HR, variability (standard deviation, pNN20, pNN50, pNN80, and rMSSD) and irregularity (approximate (APEn) and sample entropy) parameters were computed in 20-minute long non-overlapping segments. Circadian rhythmicity was evaluated using the cosinor analysis to each parameter series, that is characterized by the 24-h mean (MESOR) and the excursion over the mean (the amplitude). Arrhythmia-related symptoms were assessed by a questionnaire measuring symptoms severity (SS) and frequency (SF). HR and variability parameters showed a significant circadian variation in most patients, whereas only a small minority of the patients had circadian variation of irregularity parameters. The patients with circadian ApEn at baseline had more severe symptoms (SS = 9±4 vs. 6±5, p<0.05; circadian vs. non-circadian variation). All drugs decreased the MESOR of HR and increased the MESOR of variability parameters. Only carvedilol and metoprolol decreased the normalized amplitude over the 24-h of all parameters and HR. In conclusion, HR and RR variability parameters present a circadian variation in patients with permanent AF, whereas few patients demonstrated circadian fluctuations in irregularity parameters, suggesting different physiological mechanisms.}},
author = {{Corino, Valentina D A and Platonov, Pyotr and Enger, Steve and Tveit, Arnljot and Ulimoen, Sara R}},
issn = {{1522-1539}},
language = {{eng}},
number = {{12}},
pages = {{2152--2157}},
publisher = {{American Physiological Society}},
series = {{American Journal of Physiology: Heart and Circulatory Physiology}},
title = {{Circadian variation of variability and irregularity of heart rate in patients with permanent atrial fibrillation: Relation to symptoms and rate-control drugs.}},
url = {{http://dx.doi.org/10.1152/ajpheart.00300.2015}},
doi = {{10.1152/ajpheart.00300.2015}},
volume = {{309}},
year = {{2015}},
}