Optimal sampling interval to estimate heart rate at rest and during exercise in atrial fibrillation

Atwood, J. Edwin; Myers, Jonathan; Sandhu, Sarbjit; Lachterman, Bruce; Friis, Robert; Oshita, Anne; Forbes, Susan; Walsh, Douglas B.; Froelicher, Victor F.

doi:10.1016/0002-9149(89)91074-6

Cited by 46 publications

(18 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mean RR has been used to evaluate the average RR during AF [9][10][11]. However, the minimal number of beats from which the mean RR has been reliably obtained varied widely between only 4 beats to as many as the number of beats for 2 min among investigators and their purposes [9][10][11].…”

mentioning

confidence: 99%

“…However, the minimal number of beats from which the mean RR has been reliably obtained varied widely between only 4 beats to as many as the number of beats for 2 min among investigators and their purposes [9][10][11]. In some of these studies, mean RR was obtained to characterize the average RR even either in case of the nonnormal distribution or without testing its normality [1,5,6,[8][9][10][11].We have recently studied the frequency distributions not only of RR, but also of ventricular contractility (E max ) [12] and effective arterial elastance (E a ) [13] in in situ ejecting left ventricles during AF [14]. We have found that not only RR, but also E max , E a , and ventriculo-arterial coupling (E a /E max ) distributed nonnormally with considerable skewness (lack of symmetry of a frequency distribution) and kurtosis (peakedness or flatness of a frequency distribution) [14].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Frequency Distribution, Variance, and Moving Average of Left Ventricular Rhythm and Contractility during Atrial Fibrillation in Dog.

Morita

Araki²,

Oshima³

et al. 2002

JJP

View full text Add to dashboard Cite

Many groups in both basic and clinical studies [1][2][3][4][5][6][7][8][9] have long investigated basic statistical characteristics, including the frequency distribution of arrhythmic beat interval (RR), during atrial fibrillation (AF). Mean RR has been used to evaluate the average RR during AF [9][10][11]. However, the minimal number of beats from which the mean RR has been reliably obtained varied widely between only 4 beats to as many as the number of beats for 2 min among investigators and their purposes [9][10][11]. In some of these studies, mean RR was obtained to characterize the average RR even either in case of the nonnormal distribution or without testing its normality [1,5,6,[8][9][10][11].We have recently studied the frequency distributions not only of RR, but also of ventricular contractility (E max ) [12] and effective arterial elastance (E a ) [13] in in situ ejecting left ventricles during AF [14]. We have found that not only RR, but also E max , E a , and ventriculo-arterial coupling (E a /E max ) distributed nonnormally with considerable skewness (lack of symmetry of a frequency distribution) and kurtosis (peakedness or flatness of a frequency distribution) [14]. Their meanϮSD values could not uniquely characterize their nonnormal frequency distributions [14], unlike a normal frequency distribution [15,16].We recognized in the present study the necessity of isovolumic contractions to scrutinize the frequency distributions of E max during AF for the following reason. Although E a and E a /E max require ejecting contractions whether in situ or ex vivo [13,14,17] Key words: arrhythmia, statistics, histogram, normality, variance.Abstract: Mean levels of left ventricular rhythm and contractility averaged over arrhythmic beats would characterize the average cardiac performance during atrial fibrillation (AF). However, no consensus exists on the minimal number of beats for their reliable mean values. We analyzed their basic statistics to find out such a minimal beat number in canine hearts. We produced AF by electrically stimulating the atrium and measured left ventricular arrhythmic beat interval (RR) and peak isovolumic pressure (LVP). From these, we calculated instantaneous heart rate (HRϭ60,000/RR), contractility (E max ϭLVP/isovolumic volume above unstressed volume), and beat interval ratio (RR1/RR2). We found that all their frequency distributions during AF were variably nonnormal with skewness and kurtosis. Their meansϮstandard deviations alone cannot represent their nonnormal distributions. A 90% reduction of variances of E max and RR1/RR2 required a moving average of 15 and 24, respectively, arrhythmic beats on the average, whereas that of RR and HR required 60 beats on the average. These results indicate that a statistical characterization of arrhythmic cardiodynamic variables facilitates better understanding of cardiac performance during AF.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Frequency Distribution, Variance, and Moving Average of Left Ventricular Rhythm and Contractility during Atrial Fibrillation in Dog.

Morita

Araki²,

Oshima³

et al. 2002

JJP

View full text Add to dashboard Cite

show abstract

“…Measurements during 5 consecutive cardiac cycles representing the mean HR were averaged and used for further calculations. 13 …”

Section: Resting Echo-doppler Measurementsmentioning

confidence: 99%

“…Measurements were performed by 2 independent investigators. Be- cause the area of the LVOT and the RVOT has been shown to remain constant during exercise, 13,14 the resting values were used to calculate both rest and exercise SV. Oxygen uptake, CO2 production and minute ventilation were measured using a breath-by-breath gas analysis (Medical Graphics, St Paul, MN, USA).…”

Section: Exercise Echocardiography and Respiratory Gas Analysismentioning

confidence: 99%

Value of Echo-Doppler Derived Pulmonary Vascular Resistance, Net-Atrioventricular Compliance and Tricuspid Annular Velocity in Determining Exercise Capacity in Patients With Mitral Stenosis

Choi

Shim

Kim

et al. 2007

Circ J

View full text Add to dashboard Cite

itral stenosis (MS) is known to comprise 2 stenotic lesions: the mitral valve itself and pulmonary arteriolar stenosis, anatomically or functionally. 1,2 MS initially produces pulmonary venous hypertension and subsequently, pulmonary arterial hypertension develops because of the combined effect of back pressure, pulmonary arteriolar constriction and obliterative changes in the pulmonary vascular bed. 1,2 Pulmonary vascular resistance (PVR), representing pre-capillary resistance, reflects pulmonary arteriolar stenosis or pulmonary vascular reactivity, and is a major determinant of exercise capacity and right ventricular (RV) afterload in MS. 3 Net-atrioventricular compliance (Cn), a determinant of pressure decay across the stenotic mitral valve, is related to post-capillary resistance and is also a major determinant of inappropriate elevation of pulmonary arterial pressure during exercise. 4 could be related to increased PVR or direct RV involvement in rheumatic heart disease. 5 RV function significantly affects symptoms, exercise capacity, peri-operative mortality and postoperative results; 6 however, measurement of PVR or RV function has limitations because of the invasiveness of the procedure and the geometric complexity of the RV. Development of the Doppler technique has enabled measurement of new parameters representing PVR and RV function, 7,8 and the major advantage of these Doppler-derived parameters is that they are highly reproducible. Based on this, we aimed to determine if echo-Doppler derived PVR (PVRecho), Cn and peak systolic tricuspid annular velocity (Sa) as parameters of RV function are relevant in predicting the cardiopulmonary exercise (CPX) capacity of patients with MS. Methods Study PopulationThirty-two consecutive patients (25 females, age 52.0± 9.4 years) with moderate or severe MS (mitral valve area (MVA) by 2-dimensional (2D) planimetry: 0.7-1.5 cm 2 ) were studied. Exclusion criteria included patients with left ventricular (LV) systolic dysfunction (ejection fraction (EF) <50%), mitral regurgitation more than grade I, history of underlyng ischemic heart disease or exercise-induced ST segment change on 12-lead electrocardiogram (ECG) suggeting myocardial ischemia, valvular heart disease other Background The present study sought to determine if echo-Doppler-derived pulmonary vascular resistance (PVRecho), net-atrioventricular compliance (Cn) and tricuspid peak systolic annular velocity (Sa), as parameters of right ventricular function, have value in predicting exercise capacity in patients with mitral stenosis (MS). Methods and ResultsThirty-two patients with moderate or severe MS without left ventricular systolic dysfunction were studied. After comprehensive echo-Doppler measurements, including PVRecho, tricuspid Sa and left-sided Cn, supine bicycle exercise echo and concomitant respiratory gas analysis were performed. Measurements during 5 cardiac cycles representing the mean heart rate were averaged. Increment of resting PVRecho (r= -0.416, p=0.018) and decrement of resting Sa (r=0.43...

show abstract

“…It may be useful to evaluate the heart rate response to submaximal or maximal exercise or to monitor the rate over an extended period (e.g., by 24-h Holter recording). In addition, rate variability during AF provides information about the status of the autonomic nervous system that may have independent prognostic implications [152,153,154,155]. The definition of adequate rate control has been based primarily on short-term hemodynamic benefits and has not been well studied with respect to regularity or irregularity of the ventricular response to AF, quality of life, or symptoms or development of cardiomyopathy.…”

Section: Ventricular Rate Controlmentioning

confidence: 99%

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

Cervigón¹

View full text Add to dashboard Cite

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...

show abstract

Optimal sampling interval to estimate heart rate at rest and during exercise in atrial fibrillation

Cited by 46 publications

References 13 publications

Frequency Distribution, Variance, and Moving Average of Left Ventricular Rhythm and Contractility during Atrial Fibrillation in Dog.

Frequency Distribution, Variance, and Moving Average of Left Ventricular Rhythm and Contractility during Atrial Fibrillation in Dog.

Value of Echo-Doppler Derived Pulmonary Vascular Resistance, Net-Atrioventricular Compliance and Tricuspid Annular Velocity in Determining Exercise Capacity in Patients With Mitral Stenosis

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

Contact Info

Product

Resources

About