Autonomic Nervous System Activity before Atrial Fibrillation Onset as Assessed by Heart Rate Variability
Background: Neuromodulation has been shown to increase the efficacy of atrial fibrillation (AF) ablation procedures. However, despite its ability to influence the autonomic nervous system (ANS), the exact mechanism of action remains unclear. The activity of the ANS via the intraca...
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| Format: | Article |
| Language: | English |
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IMR Press
2025-01-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/26/1/10.31083/RCM25364 |
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| author | Jean-Marie Grégoire Cédric Gilon François Marelli Pascal Godart Hugues Bersini Stéphane Carlier |
| author_facet | Jean-Marie Grégoire Cédric Gilon François Marelli Pascal Godart Hugues Bersini Stéphane Carlier |
| author_sort | Jean-Marie Grégoire |
| collection | DOAJ |
| description | Background: Neuromodulation has been shown to increase the efficacy of atrial fibrillation (AF) ablation procedures. However, despite its ability to influence the autonomic nervous system (ANS), the exact mechanism of action remains unclear. The activity of the ANS via the intracardiac nervous system (ICNS) can be inferred from heart rate variability (HRV). Therefore, this study aims to investigate the significance of changes in the ICNS prior to the onset of AF by analyzing the evolution of HRV in a large new cohort of patients. Methods: We selected and annotated recordings with AF and atrial flutter from our database of 95,871 Holter recordings. Each recording included both sinus rhythm and one or more AF episodes. We computed parameters estimating parasympathetic activity (root mean square of successive RR interval differences (RMSSD) and percentage of successive RR intervals that differ by more than 50 ms (pNN50)), as well as HRV frequential parameters a few minutes before AF onset. To allow a minute-by-minute assessment of the parameter changes, we computed their values over 5-minute sliding windows, starting at 35 minutes before AF onset. Results: The mean age of the whole group of patients was 71.1 ± 11.3 years (range 35–99), the total number of episodes was 1319 on 623 recordings from 570 patients, with an average of 2.1 ± 2.2 episodes per recording (range 1–17) and 2.3 ± 2.6 episodes per patient (range 1–21). The proportion of premature atrial contractions (PACs) increased from 4.8 ± 0.3%, 35 minutes before the onset of AF to 8.3 ± 0.4%, 5 minutes before the AF episode. We measured a statistically significant increase in very-low-frequency (VLF), low-frequency (LF), high-frequency (HF), RMSSD and pNN50 between 35 minutes and 5 minutes before AF onset. Conclusions: Our data suggest that a significant short-term increase in vagal activity precedes most AF events. Dynamic changes in HRV parameters could be considered when determining the optimal neuromodulation strategies. |
| format | Article |
| id | doaj-art-83c8d5ca55684225a4ba325cbd988cc8 |
| institution | Kabale University |
| issn | 1530-6550 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj-art-83c8d5ca55684225a4ba325cbd988cc82025-01-25T10:41:19ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-01-012612536410.31083/RCM25364S1530-6550(24)01586-2Autonomic Nervous System Activity before Atrial Fibrillation Onset as Assessed by Heart Rate VariabilityJean-Marie Grégoire0Cédric Gilon1François Marelli2Pascal Godart3Hugues Bersini4Stéphane Carlier5IRIDIA, Université Libre de Bruxelles, 1050 Bruxelles, BelgiumIRIDIA, Université Libre de Bruxelles, 1050 Bruxelles, BelgiumISIA Lab, Université de Mons, 7000 Mons, BelgiumCHU Helora, Site Kennedy, 7000 Mons, BelgiumIRIDIA, Université Libre de Bruxelles, 1050 Bruxelles, BelgiumCardiology Department, Université de Mons, 7000 Mons, BelgiumBackground: Neuromodulation has been shown to increase the efficacy of atrial fibrillation (AF) ablation procedures. However, despite its ability to influence the autonomic nervous system (ANS), the exact mechanism of action remains unclear. The activity of the ANS via the intracardiac nervous system (ICNS) can be inferred from heart rate variability (HRV). Therefore, this study aims to investigate the significance of changes in the ICNS prior to the onset of AF by analyzing the evolution of HRV in a large new cohort of patients. Methods: We selected and annotated recordings with AF and atrial flutter from our database of 95,871 Holter recordings. Each recording included both sinus rhythm and one or more AF episodes. We computed parameters estimating parasympathetic activity (root mean square of successive RR interval differences (RMSSD) and percentage of successive RR intervals that differ by more than 50 ms (pNN50)), as well as HRV frequential parameters a few minutes before AF onset. To allow a minute-by-minute assessment of the parameter changes, we computed their values over 5-minute sliding windows, starting at 35 minutes before AF onset. Results: The mean age of the whole group of patients was 71.1 ± 11.3 years (range 35–99), the total number of episodes was 1319 on 623 recordings from 570 patients, with an average of 2.1 ± 2.2 episodes per recording (range 1–17) and 2.3 ± 2.6 episodes per patient (range 1–21). The proportion of premature atrial contractions (PACs) increased from 4.8 ± 0.3%, 35 minutes before the onset of AF to 8.3 ± 0.4%, 5 minutes before the AF episode. We measured a statistically significant increase in very-low-frequency (VLF), low-frequency (LF), high-frequency (HF), RMSSD and pNN50 between 35 minutes and 5 minutes before AF onset. Conclusions: Our data suggest that a significant short-term increase in vagal activity precedes most AF events. Dynamic changes in HRV parameters could be considered when determining the optimal neuromodulation strategies.https://www.imrpress.com/journal/RCM/26/1/10.31083/RCM25364atrial fibrillationheart rate variabilityautonomic nervous systemspectral analysis neuromodulation |
| spellingShingle | Jean-Marie Grégoire Cédric Gilon François Marelli Pascal Godart Hugues Bersini Stéphane Carlier Autonomic Nervous System Activity before Atrial Fibrillation Onset as Assessed by Heart Rate Variability Reviews in Cardiovascular Medicine atrial fibrillation heart rate variability autonomic nervous system spectral analysis neuromodulation |
| title | Autonomic Nervous System Activity before Atrial Fibrillation Onset as Assessed by Heart Rate Variability |
| title_full | Autonomic Nervous System Activity before Atrial Fibrillation Onset as Assessed by Heart Rate Variability |
| title_fullStr | Autonomic Nervous System Activity before Atrial Fibrillation Onset as Assessed by Heart Rate Variability |
| title_full_unstemmed | Autonomic Nervous System Activity before Atrial Fibrillation Onset as Assessed by Heart Rate Variability |
| title_short | Autonomic Nervous System Activity before Atrial Fibrillation Onset as Assessed by Heart Rate Variability |
| title_sort | autonomic nervous system activity before atrial fibrillation onset as assessed by heart rate variability |
| topic | atrial fibrillation heart rate variability autonomic nervous system spectral analysis neuromodulation |
| url | https://www.imrpress.com/journal/RCM/26/1/10.31083/RCM25364 |
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