Double-peaking circadian variation in the occurrence of sustained supraventricular tachyarrhythmias

Kupari, Markku; Koskinen, Pekka; Leinonen, Hannu

doi:10.1016/0002-8703(90)90249-w

Cited by 48 publications

(26 citation statements)

References 22 publications

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“…17,18) However, there are studies demonstrating a double-peak with a peak occurring with PSVT in the morning in addition to the afternoon peak. 16,19) Plasma concentration was higher during the daytime (8:00 am to 6:00 pm) than at night in patients with essential hypertension.…”

Section: Holter Monitoring and Atrial Fibrillationmentioning

confidence: 93%

“…[15][16][17][18][26][27][28][29][30] Some of them have demonstrated a double-peak occurrence of PAF with morning and evening, 16,29) whereas the otherers showed peaks during midnight and in the morning, 17) or after lunch and at midnight. 27) Also, there are studies demonstrating a much higher occurrence during the day than at night, 26,28) triple peaks-noon to 2:00 pm, 6:00 pm to 2:00 am and 4:00 am to 6:00 am, 30) and no circadian distribution.…”

Section: Paroxysmal Atrial Fibrillationmentioning

confidence: 99%

“…[9][10][11] There are also many reports regarding the circadian distribution of the occurrence of episodes of paroxysmal supraventricular tachycardia (PSVT). [12][13][14][15][16][17][18][19] In recent years, heart rate variability (HRV) analysis has enabled us to provide a quantitative evaluation of sympathovagal interaction in patients with cardiac disorders. Reduced vagal and augmented sympathetic activities have been increasingly linked to life-threatening ventricular arrhythmias, sudden cardiac death, total mortality after myocardial infarction, and congestive heart failure.…”

Section: Introductionmentioning

confidence: 99%

“…24) Atrial fibrillation is a common arrhythmia with or without structural heart disease. 25) Especially, initiation of paroxysmal atrial fibrillation (PAF) in patients with non-structural heart disease (NHD) is reportedly associated with specific circadian distribution 13,[15][16][17][18][26][27][28][29][30] and with changes of sympathetic or vagal tone seen clinically [31][32][33] or with HRV analysis. 28,[34][35][36][37][38] In this article we reviewed the circadian distribution of PAF and the effect of autonomic tone modification on PAF initiation.…”

Section: Introductionmentioning

confidence: 99%

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Circadian Distribution and Autonomic Tone Modulation in Paroxysmal Atrial Fibrillation

Tanabe

2008

Journal of Arrhythmia

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Understanding the role played by autonomic tone changes in the initiation of paroxysmal atrial fibrillation (PAF) may be helpful in preventing the occurrence of the arrhythmia. The purpose of this review article is to discuss the relationship between sympathovagal imbalance and the initiation of PAF from past literature and our data regarding circadian distribution and heart rate variability (HRV) analysis in PAF. PAF in non-structural heart disease (NHD) frequently occurs during evening and night hours with a longer duration of each episode, and its initiation is directly associated with an increase in vagal tone. According to our data of HRV analysis in NHD, HF power (indicator of vagal tone) showed a reduction 15 to 30 minutes before PAF, followed by a sharp increase immediately before the onset, suggesting a primary increase in sympathetic tone followed by a marked changes toward vagal predominance. Very few studies have been reported on PAF onset or the modulation of autonomic tone in structural heart disease (SHD). Some studies showed no significant differences in the circadian variation of the onset between NHD and SHD. However, we demonstrated a triphasic circadian pattern with maximum peaks in early morning, late afternoon, and night in SHD, suggesting an association with not only a vagally induced origin but also a sympathecally induced or stress triggered origin in PAF onset in SHD. The occurrence of PAF greatly depends on modulation of autonomic tone and is extremely complicated. Further studies are required to clarify the relationship between the occurrence of PAF and autonomic modulation. (J Arrhythmia 2008; 24: 122-132)

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Section: Holter Monitoring and Atrial Fibrillationmentioning

confidence: 93%

Section: Paroxysmal Atrial Fibrillationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Circadian Distribution and Autonomic Tone Modulation in Paroxysmal Atrial Fibrillation

Tanabe

2008

Journal of Arrhythmia

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“…However, a physiologically plausible direct effector mechanism exists probably for only four modulators, i.e., autonomic modulations, including those due to postural changes, core body temperature, atrial stretch, and hormonal changes. Previous studies have demonstrated a circadian pattern of symptomatic, out-of-hospital [245,246], paroxysmal AF, in a very large number of patients, significantly more episodes of AF occurred in the morning (and to a lesser degree late in the evening) than during the afternoon and late night hours. This diurnal variation is similar to that reported previously for other cardiovascular syndromes, including out-of-hospital sudden death [233], stroke [247], and myocardial infarction [232] or ischaemia [234,248,249,250,251,252].…”

Section: Circadian Rhythmsmentioning

confidence: 85%

Signal processing of intracardiac recordings for the evaluation of propofol effects during atrial fibrillation.

Cervigón¹

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Empieza por hacer lo necesario, luego lo posible y de pronto te encontrarás haciendo lo imposible.San Francisco de Asís. AgradecimientosEl origen de esta tesis hay que remontarlo a una pregunta que se fraguó en la unidad de arritmias del hospital clínico San Carlos de Madrid, y que la providencia llevó a mis manos a través del Dr. Javier Moreno, mi gratitud haciaél es inmensa, por su inicial confianza, y por ser guía y maestro en tan ajenas materias. Mi mayor reconocimiento a mis directores de tesis, los doctores Francisco Castells, que a pesar de la distancia física ha estado siempre cerca con suánimo y apoyo, y ha sido un auténtico maestro del que sigo aprendiendo, gracias por tu ayuda y por alimentar en mí el interés por la investigación y César Sánchez, que ha sido compaero, tutor y ejemplo desde mi inicio en la universidad, gracias por ensearme como con el trabajo y el buen hacer se puede alcanzar cualquier meta. También quiero mostrar mi gratitud a José Millet, por introducirme en este mundo, haciéndome desde el principio un hueco en su laboratorio y en su grupo. Gracias también a los profesores que me acogieron en varias estancias de investigación realizadas durante el periodo doctoral, en los grupos conducidos por el profesor Richard Reilly en el University College Dublin y en el Trinity College, agradecer su hospitalidad y la ayuda recibida, esperando que esta colaboración siga viva por muchos años.También quiero dar las gracias a todos que me abrieron su puerta en tiempos difíciles, a todos aquellos con que aprendí a sonreír ante los inconvenientes, en definitiva a todos los que contribuyereron a que esta semilla diera fruto.Porúltimo, mi más profundo y sincero agradecimiento va dirigido a toda mi familia, en especial a mis padres y hermano, este trabajo es vuestro, por creer en mí, por vuestra paciencia inagotable y por vuestro amor incondicional. SumariLa fibrilació auricular (FA)és l'arítmia més freqüent en la pràctica clínica, amb una prevalència que arriba fins el 10% en la població major de 70 anys, i unes perspectives d'increment en consonància amb l'augment de l'esperana de vida. No obstant, malgrat ser l'arítmia més freqüent, els mecanismes causants de la seua generació i persistència no se coneixen amb exactitud. Per aquesta raó, els estudis encaminats al millor coneixement d'aquesta arítmia poden ser de gran ajuda per al desenvolupament de protocols clínics que milloren el diagnòstic i permeten seleccionar els tractaments més adequats. Nombrosos estudis científics han indagat en quins són els factors que afecten a l'estat electrofisiològic de les aurícules, responsables de la iniciació i manteniment de la fibrilació, així com en els que governen la transmissió dels impulsos elèctrics entre l'aurícula i el ventricle, d'on entre ells, s'ha apuntat el sistema nerviós autònom com un dels factors responsables.En aquesta tesi doctoral s'ha estudiat l'efecte sobre l'activitat auricular i ventricular, de l'anestsic més comunament emprat en teràpies destinades a restablir el ritme sinusal en pacient...

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Circadian Distribution of In-Hospital Cardiopulmonary Arrests on the General Medical Ward

Buff¹

1992

Arch Intern Med

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Double-peaking circadian variation in the occurrence of sustained supraventricular tachyarrhythmias

Cited by 48 publications

References 22 publications

Circadian Distribution and Autonomic Tone Modulation in Paroxysmal Atrial Fibrillation

Circadian Distribution and Autonomic Tone Modulation in Paroxysmal Atrial Fibrillation

Signal processing of intracardiac recordings for the evaluation of propofol effects during atrial fibrillation.

Circadian Distribution of In-Hospital Cardiopulmonary Arrests on the General Medical Ward

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