Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation
Abstract Background Pulmonary vein isolation (PVI) is a cornerstone therapy for paroxysmal atrial fibrillation (PAF). The variations in nonlinear heart rate variability (HRV) between patients with and without recurrences remain unclear. We aimed to characterize the nonlinear HRV before and after PVI...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Annals of Noninvasive Electrocardiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/anec.13074 |
| _version_ | 1797693233018437632 |
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| author | Ting‐Wei Ernie Liao Cheng‐Hung Li Yenn‐Jiang Lin Shih‐Lin Chang Yu‐Feng Hu Fa‐Po Chung Tze‐Fan Chao Jo‐Nan Liao Hui‐Wen Yang Men‐Tzung Lo Shih‐Ann Chen Li‐Wei Lo |
| author_facet | Ting‐Wei Ernie Liao Cheng‐Hung Li Yenn‐Jiang Lin Shih‐Lin Chang Yu‐Feng Hu Fa‐Po Chung Tze‐Fan Chao Jo‐Nan Liao Hui‐Wen Yang Men‐Tzung Lo Shih‐Ann Chen Li‐Wei Lo |
| author_sort | Ting‐Wei Ernie Liao |
| collection | DOAJ |
| description | Abstract Background Pulmonary vein isolation (PVI) is a cornerstone therapy for paroxysmal atrial fibrillation (PAF). The variations in nonlinear heart rate variability (HRV) between patients with and without recurrences remain unclear. We aimed to characterize the nonlinear HRV before and after PVI in patients with and without recurrence. Methods Twenty‐five drug‐refractory PAF patients (56.0 ± 9.1 years old, 20 males) who received PVI were enrolled. Holter electrocardiography were performed before, 1–3, and 6–12 months after PVI. After 8.2 ± 2.5 months of follow‐ups after PVI, patients were divided into two groups: the recurrence (n = 8) and non‐recurrence (n = 17) groups. Linear and nonlinear HRV variables were analyzed, including the Poincaré Plot analysis and the Detrended Fluctuation Analysis (DFA). Results The non‐recurrence group, but not the recurrence group, had decreased high‐frequency component (HF), the root mean square of successive RR interval differences (RMSSD), and the Poincaré Plot index SD1 1–3 months after PVI and increased DFAslope2 6–12 months after PVI. The non‐recurrence group's LF/HF ratio and DFAslope1 decreased significantly 1–3 and 6–12 months after PVI, respectively, whereas there was no significant change in the recurrence group after PVI. Conclusions Significantly reduced vagal tone 1–3 months after PVI, increased long‐term fractal complexity 6–12 months after PVI, and decreased sympathetic tone as well as short‐term fractal complexity 1–3 and 6–12 months after PVI led to a better AF‐free survival after PVI. These findings suggest that neuromodulation and heart rate dynamics play crucial roles in AF recurrence following PVI. |
| first_indexed | 2024-03-12T02:40:36Z |
| format | Article |
| id | doaj.art-bd606cf590cb43349d7c976bd2cc41f7 |
| institution | Directory Open Access Journal |
| issn | 1082-720X 1542-474X |
| language | English |
| last_indexed | 2024-03-12T02:40:36Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj.art-bd606cf590cb43349d7c976bd2cc41f72023-09-04T07:18:39ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2023-09-01285n/an/a10.1111/anec.13074Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolationTing‐Wei Ernie Liao0Cheng‐Hung Li1Yenn‐Jiang Lin2Shih‐Lin Chang3Yu‐Feng Hu4Fa‐Po Chung5Tze‐Fan Chao6Jo‐Nan Liao7Hui‐Wen Yang8Men‐Tzung Lo9Shih‐Ann Chen10Li‐Wei Lo11Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University Taipei TaiwanCardiovascular Center Taichung Veterans General Hospital Taichung TaiwanFaculty of Medicine, School of Medicine National Yang Ming Chiao Tung University Taipei TaiwanFaculty of Medicine, School of Medicine National Yang Ming Chiao Tung University Taipei TaiwanFaculty of Medicine, School of Medicine National Yang Ming Chiao Tung University Taipei TaiwanFaculty of Medicine, School of Medicine National Yang Ming Chiao Tung University Taipei TaiwanFaculty of Medicine, School of Medicine National Yang Ming Chiao Tung University Taipei TaiwanFaculty of Medicine, School of Medicine National Yang Ming Chiao Tung University Taipei TaiwanDepartment of Biomedical Sciences and Engineering, Institute of Translational and Interdisciplinary Medicine National Central University Taoyuan TaiwanDepartment of Biomedical Sciences and Engineering, Institute of Translational and Interdisciplinary Medicine National Central University Taoyuan TaiwanFaculty of Medicine, School of Medicine National Yang Ming Chiao Tung University Taipei TaiwanFaculty of Medicine, School of Medicine National Yang Ming Chiao Tung University Taipei TaiwanAbstract Background Pulmonary vein isolation (PVI) is a cornerstone therapy for paroxysmal atrial fibrillation (PAF). The variations in nonlinear heart rate variability (HRV) between patients with and without recurrences remain unclear. We aimed to characterize the nonlinear HRV before and after PVI in patients with and without recurrence. Methods Twenty‐five drug‐refractory PAF patients (56.0 ± 9.1 years old, 20 males) who received PVI were enrolled. Holter electrocardiography were performed before, 1–3, and 6–12 months after PVI. After 8.2 ± 2.5 months of follow‐ups after PVI, patients were divided into two groups: the recurrence (n = 8) and non‐recurrence (n = 17) groups. Linear and nonlinear HRV variables were analyzed, including the Poincaré Plot analysis and the Detrended Fluctuation Analysis (DFA). Results The non‐recurrence group, but not the recurrence group, had decreased high‐frequency component (HF), the root mean square of successive RR interval differences (RMSSD), and the Poincaré Plot index SD1 1–3 months after PVI and increased DFAslope2 6–12 months after PVI. The non‐recurrence group's LF/HF ratio and DFAslope1 decreased significantly 1–3 and 6–12 months after PVI, respectively, whereas there was no significant change in the recurrence group after PVI. Conclusions Significantly reduced vagal tone 1–3 months after PVI, increased long‐term fractal complexity 6–12 months after PVI, and decreased sympathetic tone as well as short‐term fractal complexity 1–3 and 6–12 months after PVI led to a better AF‐free survival after PVI. These findings suggest that neuromodulation and heart rate dynamics play crucial roles in AF recurrence following PVI.https://doi.org/10.1111/anec.13074atrial fibrillationdetrended fluctuation analysisheart rate variabilitynonlinear heart rate variabilityPoincaré plot analysis |
| spellingShingle | Ting‐Wei Ernie Liao Cheng‐Hung Li Yenn‐Jiang Lin Shih‐Lin Chang Yu‐Feng Hu Fa‐Po Chung Tze‐Fan Chao Jo‐Nan Liao Hui‐Wen Yang Men‐Tzung Lo Shih‐Ann Chen Li‐Wei Lo Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation Annals of Noninvasive Electrocardiology atrial fibrillation detrended fluctuation analysis heart rate variability nonlinear heart rate variability Poincaré plot analysis |
| title | Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation |
| title_full | Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation |
| title_fullStr | Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation |
| title_full_unstemmed | Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation |
| title_short | Fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation |
| title_sort | fractal complexity alternations in paroxysmal atrial fibrillation patients with and without recurrence after pulmonary vein isolation |
| topic | atrial fibrillation detrended fluctuation analysis heart rate variability nonlinear heart rate variability Poincaré plot analysis |
| url | https://doi.org/10.1111/anec.13074 |
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