[Investigation of heart rate turbulence after atrial premature beats before onset of paroxysmal atrial fibrillation].
OBJECTIVE
To discuss the clinical significance of heart rate turbulence (HRT) after atrial premature beats in accessing the temporal changes of vagus nerve before the onset of paroxysmal atrial fibrillation.


METHODS
The HRT parameters: turbulence onset (TOA) and turbulence slope (TSA) after atrial premature impulses occurring 0 to 60 min before and after the onset of AF 56 patients with atrial fibrillation (AF). The heart rate variability (HRV) time domain parameter SDNN and the frequency-domain parameters, low frequency (LF), high frequency (HF), and LF/HF ratio were also analyzed. TOA and TSA were calculated for 3 periods reflecting morning hours (6-10 am), afternoon hours (1-5 pm), and night hours (0-4 am).


RESULTS
(1) The TOA and TSA were significantly higher 1 h preceding AF than 1 h after AF(0.47+/-0.32 vs 0.24+/-0.18 and 16+/-6 vs 13+/-4, both P<0.05). The HRV time domain parameters and frequency-domain parameters did not change remarkably after the onset of PAF. (2) The TOA and TSA were significantly higher in night hours than in morning hours (1.2+/-0.6 vs 0.8+/-0.4 and 17+/-6 vs 14+/-4 respectively, both P<0.05), the two parameters of HRT maintained significant circadian variations.


CONCLUSIONS
Vagal inhibition in response to premature atrial excitation is absent and transient enhancement of vagal outflow would occur before AF. HRT before atrial premature beats is of significance in accessing the changes of autonomic nervous system before onset of AF.
Qu
Xiu-fen
XF
Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
Liu
Li
L
Guo
Xiao-ning
XN
Piao
Jing-yan
JY
Gao
Guan-yu
GY
Huang
Yong-lin
YL
D000328:Adult; D001281:Atrial Fibrillation / Q000503:physiopathology*; D018880:Atrial Premature Complexes / Q000503:physiopathology*; D002940:Circadian Rhythm; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D014630:Vagus Nerve / Q000503:physiopathology