Cardiac Autonomic Dysfunction and Incidence of de novo Atrial Fibrillation: Heart Rate Variability vs. Heart Rate Complexity.

Autor:	Wessel N; Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany., Berg K; Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany., Kraemer JF; Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany., Gapelyuk A; Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany., Rietsch K; BIOTRONIK, Berlin, Germany., Hauser T; BIOTRONIK, Berlin, Germany., Kurths J; Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany.; Potsdam Institute for Climate Impact Research, Potsdam, Germany.; Centre for Analysis of Complex Systems, Sechenov First Moscow State Medical University, Moscow, Russia., Wenzel D; Clinic for Cardiology and Angiology, University Hospital Magdeburg, Magdeburg, Germany., Klein N; St. Georg Hospital, Leipzig, Germany., Kolb C; Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Faculty of Medicine, Technische Universität München, Munich, Germany., Belke R; BIOTRONIK, Berlin, Germany., Schirdewan A; Sana Klinikum Lichtenberg, Berlin, Germany., Kääb S; Medical Center of Ludwig-Maximilians-University of Munich, Munich, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in physiology [Front Physiol] 2020 Dec 08; Vol. 11, pp. 596844. Date of Electronic Publication: 2020 Dec 08 (Print Publication: 2020).
DOI:	10.3389/fphys.2020.596844
Abstrakt:	Background: The REACT DX registry evaluates standard therapies to episodes of long-lasting atrial tachyarrhythmias and assesses the quality of sensing and stability of the lead and the implantable cardioverter-defibrillator (ICD) (BIOTRONIK Lumax VR-T DX and successors) over at least a 1-year follow-up period. Objective: To study the association between the risk of de novo device-detected atrial fibrillation (AF), the autonomic perturbations before the onset of paroxysmal AF and a 7-days heart rate variability (7dHRV) 1 month after ICD implantation. Methods: The registry consists of 234 patients implanted with an ICD, including 10 with de novo long-lasting atrial tachyarrhythmias with no prior history of AF. The patients were matched via the propensity-score methodology as well as for properties directly influencing the ECGs recorded using GE CardioMem CM 3000. Heart rate variability (HRV) analysis was performed using standard parameters from time- and frequency-domains, and from non-linear dynamics. Results: No linear HRV was associated with an increased risk of AF ( p = n.s.). The only significant approach was derived from symbolic dynamics with the parameter "forbidden words" which distinguished both groups on all 7 days of measurements ( p < 0.05), thereby quantifying the heart rate complexity (HRC) as drastically lower in the de novo AF group. Conclusion: Cardiac autonomic dysfunction denoted by low HRC may be associated with higher AF incidence. For patients with mild to moderate heart failure, standard HRV parameters are not appropriate to quantify cardiac autonomic perturbations before the onset of AF. Further studies are needed to determine the individual risk for AF that would enable interventions to restore autonomic balance in the general population. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2020 Wessel, Berg, Kraemer, Gapelyuk, Rietsch, Hauser, Kurths, Wenzel, Klein, Kolb, Belke, Schirdewan and Kääb.)
Databáze:	MEDLINE
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