Tomoda Y, Uemura S, Fujimoto S, Yamamoto H, Matsukura Y, Hashimoto T, Dohi K
First Department of Internal Medicine, Nara Medical University.
J Cardiol. 1998 Jan;31(1):11-7.
Autonomic nervous activity is involved in the onset of paroxysmal atrial fibrillation, but it is not clear how the sympathetic and parasympathetic nervous systems interact before the onset of atrial fibrillation. Twelve lone atrial fibrillation patients and 10 healthy volunteers were studied using 24-hour Holter electrocardiography monitoring. A total of 17 episodes were analyzed. Autonomic nervous activity was assessed based on the high frequency power (HF) spectrum (HF represents parasympathetic nervous activity) and the ratio to the low frequency power (LF) spectrum (L/H represents sympathetic nervous activity) of heart rate variability during sinus rhythm, and the 24-hour averaged autonomic indices were compared between atrial fibrillation patients and healthy volunteers. Comparative data were obtained 30, 20, 10, and 2 min before the onset of atrial fibrillation for each episode. There were no significant differences in the HF and L/H ratio between the patients and healthy volunteers. There were no significant differences in the HF values before the onset of paroxysmal atrial fibrillation, but the L/H ratio before the onset of atrial fibrillation at 30, 20 and 10 min was 1.03 +/- 0.42, 0.95 +/- 0.50, and 1.32 +/- 0.46, respectively, and just before the episode was 1.73 +/- 0.73, so the Spearman's rank correlation coefficient was 0.43. Basal autonomic nervous activity in patients with paroxysmal atrial fibrillation showed no changes compared with healthy volunteers. Sympathetic nervous activity increased progressively from about 30 min before the onset of atrial fibrillation, but parasympathetic nervous activity showed no significant changes. Therefore, a transient augmentation of sympathetic tone may be important in the onset of atrial fibrillation.
自主神经活动参与阵发性心房颤动的发作，但在心房颤动发作前交感神经系统和副交感神经系统如何相互作用尚不清楚。采用24小时动态心电图监测对12例孤立性心房颤动患者和10名健康志愿者进行了研究。共分析了17次发作。基于窦性心律期间心率变异性的高频功率（HF）谱（HF代表副交感神经活动）和与低频功率（LF）谱的比值（L/H代表交感神经活动）评估自主神经活动，并比较心房颤动患者和健康志愿者的24小时平均自主神经指数。对于每次发作，在心房颤动发作前30、20、10和2分钟获取比较数据。患者和健康志愿者之间的HF和L/H比值无显著差异。阵发性心房颤动发作前的HF值无显著差异，但心房颤动发作前30、20和10分钟时的L/H比值分别为1.03±0.42、0.95±0.50和1.32±0.46，发作前即刻为1.73±0.73，因此Spearman等级相关系数为0.43。阵发性心房颤动患者的基础自主神经活动与健康志愿者相比无变化。交感神经活动从心房颤动发作前约30分钟开始逐渐增加，但副交感神经活动无显著变化。因此，交感神经张力的短暂增强可能在心房颤动的发作中起重要作用。
