Circadian Variations in Atrial Fibrillatory Frequency in Persistent Human Atrial Fibrillation

Atrial fibrillatory frequency reflects the atrial refractory period during AF. This study was conducted to investigate noninvasively the diurnal fluctuations of fibrillatory frequency in persistent human atrial fibrillation and to determine the relationship between changes in ventricular rate and fi...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 2000-11, Vol.23 (11P2), p.1867-1871
Main Authors: BOLLMANN, ANDREAS, SONNE, KAI, ESPERER, HANS-DIETER, TOEPFFER, INES, KLEIN, HELMUT U.
Format: Article
Language:English
Subjects:
Adult
Aged
atrial fibrillation
Atrial Fibrillation - diagnosis
Atrial Fibrillation - physiopathology
autonomic nervous system
Circadian Rhythm
Electrocardiography, Ambulatory
Female
Fourier Analysis
Heart Rate
Heart Ventricles - physiopathology
Holter ECG
Humans
Male
Middle Aged
Predictive Value of Tests
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Summary:Atrial fibrillatory frequency reflects the atrial refractory period during AF. This study was conducted to investigate noninvasively the diurnal fluctuations of fibrillatory frequency in persistent human atrial fibrillation and to determine the relationship between changes in ventricular rate and fibrillatory frequency. Ambulatory ECGs were recorded in 30 patients (18 men, 12 women, mean age 60 ± 11 years) with persistent AF (< 24 hours). AF frequency was measured in 1‐minute ECG segments by subtracting averaged QRST complexes and applying Fourier analysis to the resulting signals at 4 pm, 10 pm, 4 am, and 10 am. Peak frequency was determined in the 3–12 Hz frequency band. Mean fibrillatory frequency measured 6.6 ± 0.6 Hz (range 5.0–7.8 Hz). Two different frequency patterns were distinguished comparing maximal diurnal versus nocturnal fibrillatory frequency. In six (20%) patients an increase (P = 0.045) in nocturnal fibrillatory frequency (type I) was found. In the remaining 24 (80%) patients a decrease (P < 0.001) in fibrillatory frequency occurred (type II). Type I AF showed a strong inverse correlation between relative changes (percent) in ventricular rate and fibrillatory frequency obtained from two consecutive measurement points (r = −0.88 to −.97, P < 0.01), whereas in type II AF a moderate positive correlation (r = 0.36 to 0.41, P < 0.05) was detected. These data indicate a circadian pattern in AF frequency that concurs with ventricular rate changes suggesting a modulating influence of the autonomic nervous system on atrial electrophysiology in persistent human AF.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.2000.tb07040.x