Poincaré plots and tachograms reveal beat patterning in sick sinus syndrome with supraventricular tachycardia and varying AV nodal block

Gladuli, Andrea; Moı̈se, N. Sydney; Hemsley, Shari A.; Otani, Niels F.

doi:10.1016/j.jvc.2010.12.001

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…SD1, SD2 and their ratio SD1/SD2 have previously been applied in the measurement of nonlinear cardiac activities [18,19,22,23,29]. For instance, lower SD1 and SD2 often imply the decrease of HRV.…”

Section: Poincaré Plotmentioning

confidence: 99%

“…As a simple yet powerful nonlinear measure, the quantifications of the Poincaré plot have recently been proposed to characterize the vagal modulation of R-R interval dynamics [18,19,21,22]. The Poincaré plot provides a useful visualisation of HRV by representing both shortand long-term variations in the R-R intervals, and its geometrical representations can reflect the cardiac behavior, e.g., a normal or reduced cardiac autonomic modulation [23]. Meanwhile, a physiological model for the Poincaré plot has been established and tested by Brennan and colleagues, in which the Poincaré plot is linked to the weighted combination of low and high frequency components in HRV [24].…”

Section: Introductionmentioning

confidence: 99%

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Influence of computer work under time pressure on cardiac activity

Shi

2015

Computers in Biology and Medicine

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Section: Poincaré Plotmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of computer work under time pressure on cardiac activity

Shi

2015

Computers in Biology and Medicine

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“…We, and others, have observed the unique beat patterning of changes in heart rate in the dog using geometric heart rate variability (Moïse et al, 2010;Gladuli et al, 2011;Blake et al, 2018). However, as the heart rhythm is nonstationary and two-dimensional methods do not permit thorough examination, expanded techniques are required to understand the dynamics of heart rate variability.…”

Section: Introductionmentioning

confidence: 99%

Beat-to-Beat Patterning of Sinus Rhythm Reveals Non-linear Rhythm in the Dog Compared to the Human

2020

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The human and dog have sinus arrhythmia; however, the beat-to-beat interval changes were hypothesized to be different. Geometric analyses (R-R interval tachograms, dynamic Poincaré plots) to examine rate changes on a beat-to-beat basis were analyzed along with time and frequency domain heart rate variability from 40 human and 130 canine 24-h electrocardiographic recordings. Humans had bell-shaped beat-interval distributions, narrow interval bands across time with continuous interval change and linear changes in rate. In contrast, dogs had skewed non-singular beat distributions, wide interval bands {despite faster average heart rate of dogs [mean (range); 81 (64-119)] bpm compared to humans [74.5 (59-103) p = 0.005]} with regions displaying a paucity of intervals (zone of avoidance) and linear plus non-linear rate changes. In the dog, dynamic Poincaré plots showed linear rate changes as intervals prolonged until a point of divergence from the line of identity at a mean interval of 598.5 (95% CI: 583.5-613.5) ms (bifurcation interval). The dog had bimodal beat distribution during sleep with slower rates and greater variability than during active hours that showed singular interval distributions, higher rates and less variability. During sleep, Poincaré plots of the dog had clustered or branched patterns of intervals. A slower rate supported greater parasympathetic modulation with a branched compared to the clustered distribution. Treatment with atropine eliminated the non-linear patterns, while hydromorphone shifted the bifurcated branching and beat clustering to longer intervals. These results demonstrate the unique non-linear nature of beat-to-beat variability in the dog compared to humans with increases in interval duration (decrease heart rate). These results provoke the possibility that changes are linear with a dominant sympathetic modulation and non-linear with a dominant parasympathetic modulation. The abrupt bifurcation, zone of avoidance and beat-to-beat patterning are concordant with other studies demonstrating the development of exit block from the sinus node with parasympathetic modulation influencing not only the oscillation of the pacing cells, but conduction to the atria. Studies are required to associate the in vivo sinus node beat patterns identified in this study to the mapping of sinus impulse origin and exit from the sinus node.

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“…60 Similar results were documented in dogs with sick sinus syndrome. 61 Finally, the fractal-like behavior of heart-beat intervals is closer to a white noise in sick sinus patients. 60 …”

Section: Change In Hrv and Fractal-like Behavior Of The Heart-beat Inmentioning

confidence: 96%

Impaired Signaling Intrinsic to Sinoatrial Node Pacemaker Cells Affects Heart Rate Variability during Cardiac Disease

2014

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The normal heart beat intervals are neither strictly stationary nor completely random, and continuously shift from one period to another. Decoding the ECG identifies this “hidden” information that imparts inherent complexity to the heart-beating interval time series. Loss of this complexity in cardiovascular disease is manifested as a reduction in heart rate variability (HRV) and this reduction correlates with an increase in both morbidity and mortality. Because HRV measurements are noninvasive and easy to perform, they have emerged as an important tool in cardiology. However, the identities of specific mechanisms that underline the changes in HRV that occur in cardiovascular diseases remain largely unknown. Changes in HRV have mainly been interpreted on a neural basis, ie due to changes in autonomic impulses to the heart: sympathetic activity decreases both the average heart beat interval and HRV, and parasympathetic activity increases both. It has now become clear, however, that the heart rate and HRV are also determined by intrinsic properties of the pacemaker cells that comprise the sinoatrial node, and the responses of these properties to autonomic receptor stimulation. Here we review how changes in the properties of coupled-clock mechanisms intrinsic to pacemaker cells that comprise the sinoatrial node and their impaired response to autonomic receptor stimulation are implicated in the changes of HRV observed in heart diseases.

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Poincaré plots and tachograms reveal beat patterning in sick sinus syndrome with supraventricular tachycardia and varying AV nodal block

Cited by 17 publications

References 14 publications

Influence of computer work under time pressure on cardiac activity

Influence of computer work under time pressure on cardiac activity

Beat-to-Beat Patterning of Sinus Rhythm Reveals Non-linear Rhythm in the Dog Compared to the Human

Impaired Signaling Intrinsic to Sinoatrial Node Pacemaker Cells Affects Heart Rate Variability during Cardiac Disease

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