Restoring Sinus Rhythm Improves Baroreflex Function in Patients With Persistent Atrial Fibrillation

BackgroundStudies have suggested that patients with atrial fibrillation (AF) have impairment in the baroreflex. It is not clear whether these findings are the result of the associated comorbid conditions or the arrhythmia itself. We hypothesized that AF is associated with impairment in baroreflex fu...

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Main Authors: Michael E. Field, Stephen L. Wasmund, Richard L. Page, Mohamed H. Hamdan
Format: Article
Language:English
Published: Wiley 2016-02-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.115.002997
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author Michael E. Field
Stephen L. Wasmund
Richard L. Page
Mohamed H. Hamdan
author_facet Michael E. Field
Stephen L. Wasmund
Richard L. Page
Mohamed H. Hamdan
author_sort Michael E. Field
collection DOAJ
description BackgroundStudies have suggested that patients with atrial fibrillation (AF) have impairment in the baroreflex. It is not clear whether these findings are the result of the associated comorbid conditions or the arrhythmia itself. We hypothesized that AF is associated with impairment in baroreflex function and that the arrhythmia itself is a contributing factor. Methods and ResultsTwenty‐four patients with persistent AF referred for cardioversion were enrolled. A second group of patients with no history of AF matched for age and left ventricular ejection fraction was identified and served as the control group. In the AF group, baroreflex gain (BRG) was measured on the day of cardioversion (Day 1) and again at 30 days post‐cardioversion (Day 30) in patients who remained in sinus rhythm (SR). The clinical characteristics of patients with AF were not different than those of the control group. The mean BRG in the AF group on Day 1 was significantly lower than the mean BRG of the control group (5.2±3.6 versus 10.8±5.5 ms/mm Hg, P<0.05). Ten patients experienced AF recurrence before the 30‐day follow‐up and 14 patients remained in SR. In the group that remained in SR, BRG increased from 4.1±3.7 ms/mm Hg on Day 1 to 7.0±6.0 ms/mm Hg on Day 30 (P<0.01). ConclusionWe have shown that AF is associated with impairment of the baroreflex and that restoration of SR improves BRG. Our data suggest that AF might be a contributing factor to the observed impairment in BRG and that restoring SR might help improve baroreflex function.
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spelling doaj.art-977b25b412c4486f8625030c695d31362022-12-21T23:53:17ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-02-015210.1161/JAHA.115.002997Restoring Sinus Rhythm Improves Baroreflex Function in Patients With Persistent Atrial FibrillationMichael E. Field0Stephen L. Wasmund1Richard L. Page2Mohamed H. Hamdan3Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WIDivision of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WIDivision of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WIDivision of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WIBackgroundStudies have suggested that patients with atrial fibrillation (AF) have impairment in the baroreflex. It is not clear whether these findings are the result of the associated comorbid conditions or the arrhythmia itself. We hypothesized that AF is associated with impairment in baroreflex function and that the arrhythmia itself is a contributing factor. Methods and ResultsTwenty‐four patients with persistent AF referred for cardioversion were enrolled. A second group of patients with no history of AF matched for age and left ventricular ejection fraction was identified and served as the control group. In the AF group, baroreflex gain (BRG) was measured on the day of cardioversion (Day 1) and again at 30 days post‐cardioversion (Day 30) in patients who remained in sinus rhythm (SR). The clinical characteristics of patients with AF were not different than those of the control group. The mean BRG in the AF group on Day 1 was significantly lower than the mean BRG of the control group (5.2±3.6 versus 10.8±5.5 ms/mm Hg, P<0.05). Ten patients experienced AF recurrence before the 30‐day follow‐up and 14 patients remained in SR. In the group that remained in SR, BRG increased from 4.1±3.7 ms/mm Hg on Day 1 to 7.0±6.0 ms/mm Hg on Day 30 (P<0.01). ConclusionWe have shown that AF is associated with impairment of the baroreflex and that restoration of SR improves BRG. Our data suggest that AF might be a contributing factor to the observed impairment in BRG and that restoring SR might help improve baroreflex function.https://www.ahajournals.org/doi/10.1161/JAHA.115.002997atrial fibrillationbaroreflex gainhypertension
spellingShingle Michael E. Field
Stephen L. Wasmund
Richard L. Page
Mohamed H. Hamdan
Restoring Sinus Rhythm Improves Baroreflex Function in Patients With Persistent Atrial Fibrillation
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
atrial fibrillation
baroreflex gain
hypertension
title Restoring Sinus Rhythm Improves Baroreflex Function in Patients With Persistent Atrial Fibrillation
title_full Restoring Sinus Rhythm Improves Baroreflex Function in Patients With Persistent Atrial Fibrillation
title_fullStr Restoring Sinus Rhythm Improves Baroreflex Function in Patients With Persistent Atrial Fibrillation
title_full_unstemmed Restoring Sinus Rhythm Improves Baroreflex Function in Patients With Persistent Atrial Fibrillation
title_short Restoring Sinus Rhythm Improves Baroreflex Function in Patients With Persistent Atrial Fibrillation
title_sort restoring sinus rhythm improves baroreflex function in patients with persistent atrial fibrillation
topic atrial fibrillation
baroreflex gain
hypertension
url https://www.ahajournals.org/doi/10.1161/JAHA.115.002997
work_keys_str_mv AT michaelefield restoringsinusrhythmimprovesbaroreflexfunctioninpatientswithpersistentatrialfibrillation
AT stephenlwasmund restoringsinusrhythmimprovesbaroreflexfunctioninpatientswithpersistentatrialfibrillation
AT richardlpage restoringsinusrhythmimprovesbaroreflexfunctioninpatientswithpersistentatrialfibrillation
AT mohamedhhamdan restoringsinusrhythmimprovesbaroreflexfunctioninpatientswithpersistentatrialfibrillation