Competing autonomic mechanisms precede the onset of postoperative atrial fibrillation Journal Article
| Authors: | Amar, D.; Zhang, H.; Miodownik, S.; Kadish, A. H. |
| Article Title: | Competing autonomic mechanisms precede the onset of postoperative atrial fibrillation |
| Abstract: | OBJECTIVES: This study was designed to evaluate autonomic changes preceding atrial fibrillation/flutter (AF) after thoracotomy. BACKGROUND: Autonomic fluctuations before the onset of postoperative AF have been reported but with conflicting results. METHODS: In 48 patients with postoperative AF, 2-h Holter recordings before the onset of AF were compared with corresponding data from 48 age- and gender-matched surgical controls without AF. Five-minute segments of heart rate variability (HRV) were studied using linear regression methods. RESULTS: There was a near-significant trend for the RR interval among patients with AF to be lower than controls (p = 0.06), whereas the standard deviation of RRs (p < 0.0001), root mean square of successive RR differences (p < 0.0001), proportion of RRs >50 ms different (p < 0.0001), low-frequency power (p = 0.0003) and its log (p < 0.0001), and high-frequency-power (p < 0.0001) and its log (p < 0.0001) were all significantly greater in patients with AF, respectively. In comparison to controls, AF patients had a significant decrease in RR interval (p = 0.02) and significant increments in all time- and frequency-domain analyses studied. CONCLUSIONS: In the period before the onset of postoperative AF, there are significant increases in HRV during a time when heart rate also increases. These novel findings are consistent with parasympathetic resurgence competing with increasing sympathetic activity as the triggering mechanism for postoperative AF. © 2003 by the American College of Cardiology Foundation. |
| Keywords: | adult; clinical article; controlled study; aged; case-control studies; pathogenesis; postoperative period; prospective studies; thoracotomy; postoperative complications; heart atrium fibrillation; atrial fibrillation; thoracic surgical procedures; linear regression analysis; heart rate; autonomic nervous system; adrenergic system; heart atrium flutter; holter monitoring; humans; human; male; female; priority journal; article; cholinergic system; heart rate variability; heart automaticity; rr interval; electrocardiography, ambulatory |
| Journal Title: | Journal of the American College of Cardiology |
| Volume: | 42 |
| Issue: | 7 |
| ISSN: | 0735-1097 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2003-10-01 |
| Start Page: | 1262 |
| End Page: | 1268 |
| Language: | English |
| DOI: | 10.1016/s0735-1097(03)00955-0 |
| PUBMED: | 14522493 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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