First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China (mainland).
Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China (mainland).
Med Sci Monit. 2022 Feb 12;28:e934028. doi: 10.12659/MSM.934028.
BACKGROUND Variations of heart rate variability (HRV) before paroxysmal atrial fibrillation (PAF) onset are still controversial. We aimed to observe the autonomic tone variations before PAF onset based on HRV analysis. MATERIAL AND METHODS We prospectively investigated 24-h Holter recordings of 60 patients with PAF (M/F: 34/26) and 40 healthy people in sinus rhythm (M/F: 18/12). According to clinical information and Poincare scatter plot, 60 PAF patients were divided into sympathetic group (n=20) and vagus group (n=40). Time domain and frequency domain parameters of HRV were respectively measured before PAF episodes in 3 subgroups. Five time periods were studied using the ANOVA. RESULTS No significant variations were observed for the HRV parameters during 60 minutes preceding PAF in sympathetic group. A significant and linear change in SDNN, RMSSD, PNN50, HF and LF/HF during 60 minutes preceding PAF onset in vagus group. Compared with controls, RMSSD, LF and HF were significantly longer in patients with PAF during 60 minutes before PAF. Comparing sympathetic group and vagus group, we observed the same pattern of autonomic variations with a progressive decrease in LF and HF. A progressive decrease in PNN50 and LF/HF of sympathetic group and a significant increase in PNN50 and LF/HF of vagus group were also observed. CONCLUSIONS Patients with PAF mediated by different autonomic nerves have HRV variations, especially vagus PAF, there was a progressive increase with vagal tone during 60 minutes before PAF onset. The findings may help clinicians better intervene in PAF.
阵发性心房颤动（PAF）发作前心率变异性（HRV）的变化仍存在争议。我们旨在通过 HRV 分析观察 PAF 发作前自主神经张力的变化。
我们前瞻性地研究了 60 例 PAF 患者（男/女：34/26）和 40 例窦性心律健康人（男/女：18/12）的 24 小时动态心电图记录。根据临床资料和 Poincaré 散点图，将 60 例 PAF 患者分为交感组（n=20）和迷走组（n=40）。在 3 个亚组中分别测量了 PAF 发作前 HRV 的时域和频域参数。使用方差分析研究了 5 个时间段。
在交感组中，PAF 发作前 60 分钟内 HRV 参数没有明显变化。在迷走组中，在 PAF 发作前 60 分钟内，SDNN、RMSSD、PNN50、HF 和 LF/HF 呈显著线性变化。与对照组相比，PAF 患者在 PAF 发作前 60 分钟内 RMSSD、LF 和 HF 明显延长。与交感组相比，迷走组观察到自主神经变化的相同模式，即 LF 和 HF 逐渐减少。迷走组的 PNN50 和 LF/HF 逐渐减少，交感组的 PNN50 和 LF/HF 显著增加。
不同自主神经介导的 PAF 患者存在 HRV 变化，尤其是迷走神经介导的 PAF，在 PAF 发作前 60 分钟内，随着迷走神经张力的增加，HRV 呈逐渐增加趋势。这些发现可能有助于临床医生更好地干预 PAF。
