Effects of consecutive administration of central and peripheral anticholinergic agents on respiratory sinus arrhythmia in normal subjects

Lacroix, Dominique; Logier, R.; Kacet, Salem; Hazard, J.-R.; J, Dagano; Lekieffre, J

doi:10.1016/0165-1838(92)90014-8

Cited by 17 publications

(3 citation statements)

References 19 publications

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“…Spectral analysis of heart rate variability was performed using a previously described system 22. The device was built with a commercially available microcomputer (IBM PC, AT compatible).…”

Section: Methodsmentioning

confidence: 99%

Inadequate sympathovagal balance in response to orthostatism in patients with unexplained syncope and a positive head up tilt test

Kouakam

Lacroix

Zghal

et al. 1999

Heart

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Aim-To analyse the immediate response of heart rate variability (HRV) in response to orthostatic stress in unexplained syncope. Subjects-69 subjects, mean (SD) age 42 (18) years, undergoing 60°head up tilt to evaluate unexplained syncope. Methods-Based on 256 second ECG samples obtained during supine and upright phases, spectral analyses of low (LF) and high frequency (HF) bands were calculated, as well as the LF/HF power ratio, reflecting the sympathovagal balance. All variables were measured just before tilt during the last five minutes of the supine position, during the first five minutes of head up tilt, and just before the end of passive tilt. Results-Symptoms occurred in 42 subjects (vasovagal syncope in 37; psychogenic syncope in five). Resting haemodynamics and HRV indices were similar in subjects with and without syncope. Immediately after assuming the upright posture, adaptation to orthostatism diVered between the two groups in that the LF/HF power ratio decreased by 11% from supine (from 2.7 (1.5) to 2.4 (1.2)) in the positive test group, while it increased by 11.5% (from 2.8 (1.5) to 3.1 (1.7)) in the negative test group (p = 0.02). This was because subjects with a positive test did not have the same increment in LF power with tilting as those with a negative test (11% v 28%, p = 0.04), while HF power did not alter. A decreased LF/HF power ratio persisted throughout head up tilt and was the only variable found to discriminate between subjects with positive and negative test results (p = 0.005, multivariate analysis). During the first five minutes of tilt, a decreased LF/HF power ratio occurred in 33 of 37 subjects in the positive group and three of 27 in the negative group. Thus a decreased LF/HF ratio had 89% sensitivity, 89% specificity, a 92% positive predictive value, and an 86% negative predictive value. Conclusions-Through the LF/HF power ratio, spectral analysis of HRV was highly correlated with head up tilt results. Subjects developing syncope late during continued head up tilt have a decrease in LF/HF ratio immediately after assuming the upright posture, implying that although symptoms have not developed the vasovagal reaction may already have begun. This emphasises the major role of the autonomic nervous system in the genesis of vasovagal (neurally mediated) syncope. (Heart 1999;82:312-318)

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“…Spectral analysis of heart rate variability was performed using a previously described system 22. The device was built with a commercially available microcomputer (IBM PC, AT compatible).…”

Section: Methodsmentioning

confidence: 99%

Inadequate sympathovagal balance in response to orthostatism in patients with unexplained syncope and a positive head up tilt test

Kouakam

Lacroix

Zghal

et al. 1999

Heart

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“…We here demonstrate for the first time a significant reduction of RSA after PVI, which is related to the decrease in cardiac vagal tone, as supported by the observed changes of resting HR and HRV in our patients. Supporting this, RSA is known to be reduced after atropine application in healthy humans [ 23 , 24 ] and is modulated in diseases such as diabetic autonomic neuropathy [ 25 , 26 ]. Although RSA also depends on feedback regulation such as chemoreceptors [ 27 ] and pulmonary afferents and is further modulated by central respiratory drive [ 28 – 32 ], the direct cardiac influence and the related decrease in intracardiac vagal control following PVI seem to be key in our patients.…”

Section: Discussionmentioning

confidence: 99%

Respiratory sinus arrhythmia is reduced after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

Jungen¹,

Alken²,

Scherschel³

et al. 2020

aoms

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Introduction: Respiratory sinus arrhythmia (RSA) describes heart rate (HR) changes in synchrony with respiration. It is relevant for exercise capacity and mechanistically linked with the cardiac autonomic nervous system. After pulmonary vein isolation (PVI), the current therapy of choice for patients with paroxysmal atrial fibrillation (AF), the cardiac vagal tone is often diminished. We hypothesized that RSA is modulated by PVI in patients with paroxysmal AF. Material and methods: Respiratory sinus arrhythmia, measured by using a deep breathing test and heart rate variability parameters, was studied in 10 patients (64 ±3 years) with paroxysmal AF presenting in stable sinus rhythm for their first catheter-based PVI. Additionally, heart rate dynamics before and after PVI were studied during sympathetic/parasympathetic coactivation by using a cold-face test. All tests were performed within 24 h before and 48 h after PVI. Results: After PVI RSA (E/I difference: 7.9 ±1.0 vs. 3.5 ±0.6 bpm, p = 0.006; E/I ratio: 1.14 ±0.02 vs. 1.05 ±0.01, p = 0.003), heart rate variability (SDNN: 31 ±3 vs. 14 ±3 ms, p = 0.006; RMSSD: 17 ±2 vs. 8 ±2 ms, p = 0.002) and the HR response to sympathetic/parasympathetic coactivation (10.2 ±0.7% vs. 5.7 ±1.1%, p = 0.014) were diminished. The PVI-related changes in RSA correlated with the heart rate change during sympathetic/parasympathetic coactivation before vs. after PVI (E/I difference: r = 0.849, p = 0.002; E/I ratio: r = 0.786, p = 0.007). One patient with vagal driven arrhythmia experienced AF recurrence during follow-up (mean: 6.5 ±0.6 months). Conclusions: Respiratory sinus arrhythmia is reduced after PVI in patients with paroxysmal AF. Our findings suggest that this is related to a decrease in cardiac vagal tone. Whether and how this affects the clinical outcome including exercise capacity need to be determined.

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“…Familiarity with the ANS state can be valuable in diagnosing many clinical cases [1,2]. Analysis of heart rate in the frequency domain is increasingly important in physiological studies, and supports the use of heart rate variability as an index of autonomic cardiovascular control.…”

Section: Introductionmentioning

confidence: 99%

A new view of a stationarity of the RR series for sinusal variability analysis

Naouar

Salah

2006

Journal of Medical Engineering & Technology

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The influence of ANS in sinusal variability is studied through analysis of RR series, and particularly RR interval variations during time. Different kinds of RR series signal analysis are applied to clinical situations found in cardiology. However, some of the RR series may be stationary as well as non-stationary. Statistical tests applied to the RR series will establish determinism and stationarity of these signals. The aim of this article is to characterize the statistical behaviour pattern of RR series in order to identify precautions that should be observed when time-frequency transform techniques are used in sinusal clinical investigations. Eight kinds of RR series concerning sinusal variability were submitted to the statistical tests. The results showed the uncertain character of the RR series and their non-stationarity. This result is consequently a warning against using several techniques of time-frequency transform for sinusal variability analysis. Some of the techniques studied are adapted to non-stationary signals under some conditions.

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Effects of consecutive administration of central and peripheral anticholinergic agents on respiratory sinus arrhythmia in normal subjects

Cited by 17 publications

References 19 publications

Inadequate sympathovagal balance in response to orthostatism in patients with unexplained syncope and a positive head up tilt test

Inadequate sympathovagal balance in response to orthostatism in patients with unexplained syncope and a positive head up tilt test

Respiratory sinus arrhythmia is reduced after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

A new view of a stationarity of the RR series for sinusal variability analysis

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