Rhythm-independent feature of heart rate dynamics common to atrial fibrillation and sinus rhythm in patients with paroxysmal atrial fibrillation.

OBJECTIVES

To examine if the long-range correlation in heart rate variability is a rhythm-independent characteristic common to both atrial fibrillation (AF) and sinus rhythm (SR) periods in patients with paroxysmal atrial fibrillation (PAF).

METHODS

Holter electrocardiography was analyzed during sleep in 18 patients with paroxysmal atrial fibrillation during the atrial fibrillation (PAF-AF) and sinus rhythm (PAF-SR) periods, and also in 19 healthy controls with sinus rhythm (CTR-SR). The heart rate dynamics were assessed with the power-law spectral exponent (slope) of the log-log power spectrum between 0.0001 Hz and the breakpoint frequency.

RESULTS

The slope showed a significant correlation between PAF-SR and PAF-AF (r = 0.614, p < 0.01). During sinus rhythm, the slope in paroxysmal atrial fibrillation with cardiovascular disease [PAF-SR (cvd+)] was steeper than that in paroxysmal atrial fibrillation without cardiovascular disease [PAF-SR (cvd-)] (p < 0.05). Although the slope was comparable between PAF-SR (cvd-) and CTR-SR, the slope in PAF-SR (cvd+) was steeper than that in CTR-SR (p < 0.05). A similar tendency was shown during atrial fibrillation. The slope in paroxysmal atrial fibrillation with cardiovascular disease [PAF-AF (cvd+)] was steeper than that in paroxysmal atrial fibrillation without cardiovascular disease [PAF-AF (cvd-)] (p < 0.05). Although the slope was comparable between PAF-AF (cvd-) and CTR-SR, the slope in PAF-AF (cvd+) tended to be steeper than that in CTR-SR.

CONCLUSIONS

The long-range correlation in heart rate variability during sleep was a rhythm-independent characteristic and so may have a similar clinical value during atrial fibrillation and sinus rhythm in patients with paroxysmal atrial fibrillation.