Cor Vasa 2004, 45(6):265-272

Cardiac autonomic nervous system testing in patients with atrial fibrillation. A summary and our own experience

Jan Galuszka^1,*, Jan Lukl¹, Jaroslav Opavský², Jiří Salinger³, Jana Zapletalová⁴

¹ I. interní klinika, Fakultní nemocnice a Lékařská fakulta Univerzity Palackého

² Katedra fyzioterapie a algoterapie

³ Katedra biomechaniky a technické kybernetiky, Fakulta tělesné kultury Univerzity Palackého

⁴ Oddělení biometrie, Lékařská fakulta Univerzity Palackého, Olomouc, Česká republika

Aim of study:
To assess cardiac autonomic control in patients with paroxysmal atrial fibrillation and echocardiographically normal left atrial size.


Group of patients and method:
The group of patients included 30 subjects free of structural heart disease, and treated for paroxysmal atrial fibrillation. Upon sinus rhythm restoration, patients were examined under standard conditions using reflex tests (deep breathing test, orthostatic test) and spectral analysis of a short-term heart rate variability recording during the supine-standing-supine. The results of reflex tests were compared with normal values reported in the literature. The results of spectral analysis of heart rate variability during the supine-standing-stupine were compared with those obtained from a control group of 30 healthy subjects.

Results:
Subjects with paroxysmal atrial fibrillation showed significantly decreased vagal activity during the deep breathing test (I-E, I/E indices; p < 0.001). The orthostatic test was significantly associated with decreased vagal activity indexes (BI index; p < 0.001) and with decreased indices comprising vagal and sympathetic autonomic nervous system components (RRmax/RRmin, RR 30 : RR 15, indices; p < 0.001). Significantly decreased total spectral performance (TOT.PWR; p < 0.001) and, particularly, vagal activity (PWR.HF; p < 0.001) were seen in the group of patients in all positions during the supine-standing-stupine.

Conclusions:
The findings indicate a significantly higher incidence of cardiac autonomic control impairment in subjects with atrial fibrillation.

Keywords: Atrial fibrillation; Autonomic nervous system; Deep breathing test; Orthostatic test; The supine-standing-supine; Heart rate variability

Published: June 1, 2004  Show citation