Competing autonomic mechanisms precede the onset of postoperative atrial fibrillation. Academic Article uri icon

Overview

abstract

  • OBJECTIVES: This study was designed to evaluate autonomic changes preceding atrial fibrillation/flutter (AF) after thoracotomy. BACKGROUND: Autonomic fluctuations before the onset of postoperative AF have been reported but with conflicting results. METHODS: In 48 patients with postoperative AF, 2-h Holter recordings before the onset of AF were compared with corresponding data from 48 age- and gender-matched surgical controls without AF. Five-minute segments of heart rate variability (HRV) were studied using linear regression methods. RESULTS: There was a near-significant trend for the RR interval among patients with AF to be lower than controls (p = 0.06), whereas the standard deviation of RRs (p < 0.0001), root mean square of successive RR differences (p < 0.0001), proportion of RRs >50 ms different (p < 0.0001), low-frequency power (p = 0.0003) and its log (p < 0.0001), and high-frequency-power (p < 0.0001) and its log (p < 0.0001) were all significantly greater in patients with AF, respectively. In comparison to controls, AF patients had a significant decrease in RR interval (p = 0.02) and significant increments in all time- and frequency-domain analyses studied. CONCLUSIONS: In the period before the onset of postoperative AF, there are significant increases in HRV during a time when heart rate also increases. These novel findings are consistent with parasympathetic resurgence competing with increasing sympathetic activity as the triggering mechanism for postoperative AF.

publication date

  • October 1, 2003

Research

keywords

  • Atrial Fibrillation
  • Autonomic Nervous System
  • Postoperative Complications
  • Thoracic Surgical Procedures

Identity

Scopus Document Identifier

  • 0141727666

Digital Object Identifier (DOI)

  • 10.1016/s0735-1097(03)00955-0

PubMed ID

  • 14522493

Additional Document Info

volume

  • 42

issue

  • 7