Impact of Sleep Apnea on Nocturnal Parasympathetic Activity in Atrial Fibrillation Patients After Catheter Ablationã- Implications for Heart Rate Variability Analysis.
Circ J
; 88(7): 1081-1088, 2024 06 25.
Article
in En
| MEDLINE
| ID: mdl-38281763
ABSTRACT
BACKGROUND:
The impact of sleep apnea (SA) on heart rate variability (HRV) in atrial fibrillation (AF) patients has not been investigated. METHODSâANDâRESULTS:
Of 94 patients who underwent AF ablation between January 2021 and September 2022, 76 patients who had a nocturnal Holter electrocardiography and polysomnography conducted simultaneously were included in the analysis. A 15-min duration of HRV, as determined by an electrocardiogram during apnea and non-apnea time, were compared between patients with and without AF recurrence at 12 months' postoperatively. Patients had a mean age of 63.4±11.6 years, 14 were female, and 20 had AF recurrence at 12 months' follow-up. The root mean square of the difference between consecutive normal-to-normal intervals (RMSSD, ms) an indicator of a parasympathetic nervous system, was more highly increased in patients with AF recurrence than those without, during both apnea and non-apnea time (apnea time 16.7±4.5 vs. 13.5±3.3, P=0.03; non-apnea time 20.9±9.5 vs. 15.5±5.9, P<0.01). However, RMSSD during an apneic state was decreased more than that in a non-apneic state in both groups of patients with and without AF recurrence (AF recurrence group 16.7±4.5 vs. 20.9±9.5, P<0.01; non-AF recurrence group; 13.5±3.3 vs. 15.5±5.9, P=0.03). Consequently, the effect of AF recurrence on parasympathetic activity was offset by SA. Similar trends were observed for other parasympathetic activity indices; high frequency (HF), logarithm of HF (lnHF) and the percentage of normal-to-normal intervals >50 ms (pNN50).CONCLUSIONS:
Without considering the influence of SA, the results of nocturnal HRV analysis might be misinterpreted. Caution should be taken when using nocturnal HRV as a predictor of AF recurrence.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Parasympathetic Nervous System
/
Atrial Fibrillation
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Sleep Apnea Syndromes
/
Electrocardiography, Ambulatory
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Catheter Ablation
/
Heart Rate
Limits:
Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Cir. j
/
Circ J
/
Circulation journal
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2024
Type:
Article