Skip to main content
View expanded cover

Clinical Autonomic Dysfunction pp 197–204Cite as

Arrhythmia

  • 1675 Accesses

Abstract

Part V moves into cardiology. This chapter considers arrhythmia. It looks at atrial fibrillation as a possible model of arrhythmia and discusses the interpretation of ANS assessment results that include high-quality arrhythmia. While traditional HRV is contraindicated for arrhythmia, P&S monitoring, as shown in the atrial fibrillation trail is not. This is the result of the more specific measures of P and S activity. Where HRV alone uses spectral analysis windows for low and high frequencies that are of different widths, the window widths for P&S monitoring are significantly more well matched. For P&S monitoring, the matched windowing enables greater noise rejection, where the arrhythmia is treated as (relatively) broad-spectrum noise. With improved noise rejection, arrhythmic records may still be interpreted. For records with arrhythmia in only one or two phases, like with pacing activation, consider the arrhythmia as a symptom, given the stimulus being presented in that phase of the assessment.

Keywords

  • Atrial Fibrillation
  • Respiratory Sinus Arrhythmia
  • Continuous Wavelet Transform
  • Sympathetic Blockade
  • Postural Orthostatic Tachycardia Syndrome

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-319-07371-2_18
  • Chapter length: 8 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   149.00
Price excludes VAT (USA)
  • ISBN: 978-3-319-07371-2
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   199.00
Price excludes VAT (USA)
Hardcover Book
USD   249.99
Price excludes VAT (USA)
Learn about institutional subscriptions
Fig. 18.1
Fig. 18.2

References

  1. Coumel P, Thomas O, Leenhardt A. Drug therapy for prevention of atrial fibrillation. Am J Cardiol. 1996;77(3):3A–9.

    CAS  PubMed  CrossRef  Google Scholar 

  2. Coumel P. Paroxysmal atrial fibrillation: a disorder of autonomic tone. Am J Cardiol. 1996;77(3):3A–9.

    CAS  PubMed  CrossRef  Google Scholar 

  3. Nanavati S, Bulgarelli RJ, Vazquez-Tanus J, Ghosh-Dastidar S, Colombo J, Arora RR. Altered autonomic activity with atrial fibrillation as demonstrated by non-invasive autonomic monitoring. American Autonomic Society, 17th international symposium, Kauai, 29 Oct–1 Nov.

    Google Scholar 

  4. Nanavati SH, Bulgarelli RJ, Vazquez-Tanus J, Ghosh-Dastidar S, Colombo J, Arora RR. Altered autonomic activity with atrial fibrillation as demonstrated by non-invasive autonomic monitoring. US Cardiol. 2010;7(1):47–50.

    Google Scholar 

  5. Low PA, editor. Clinical autonomic disorders: evaluation and management. Philadelphia: Lippincott-Raven; 1997.

    Google Scholar 

  6. Malik M. The task force of the European society of cardiology and the North American society of pacing and electrophysiology. Heart rate variability, standards of measurement, physiological interpretation, and clinical use. Circulation. 1996;93:1043–65.

    CrossRef  Google Scholar 

  7. Malik M. The task force of the European society of cardiology and the North American society of pacing and electrophysiology. Heart rate variability, standards of measurement, physiological interpretation, and clinical use. Eur Heart J. 1996;17:354–81.

    CrossRef  Google Scholar 

  8. Eckberg DL. Sympathovagal balance. A critical appraisal. Circulation. 1997;96(9):3224–32.

    CAS  PubMed  CrossRef  Google Scholar 

  9. Alcalay M, Izraeli S, Wallach R, et al. Paradoxical pharmacodynamic effect of atropine on parasympathetic control: study by spectral analysis of heart rate fluctuations. Clin Pharmacol Ther. 1992;52:518–27.

    CAS  PubMed  CrossRef  Google Scholar 

  10. Eckberg DL. Physiological basis for human autonomic rhythms. Ann Med. 2000;32:341–9.

    CAS  PubMed  CrossRef  Google Scholar 

  11. Freeman R. Assessment of cardiovascular autonomic function. Clin Neurophysiol. 2006;117(4):716–30.

    PubMed  CrossRef  Google Scholar 

  12. Cammann H, Michel L. How to avoid misinterpretation of heart rate variability power spectra? Comput Methods Programs Biomed. 2002;1:15–23.

    CrossRef  Google Scholar 

  13. Badra LJ, Cooke WH, Hoag JB, Crossman AA, Kuusela TA, Tahvanainen KU, Eckberg DL. Respiratory modulation of human autonomic rhythms. Am J Physiol Heart Circ Physiol. 2001;280(6):H2674–88.

    CAS  PubMed  Google Scholar 

  14. Brown TE, Beightol LA, Koh J, Eckberg DL. Important influence of respiration on human R-R interval power spectra is largely ignored. J Appl Physiol. 1993;75(5):2310–7.

    CAS  PubMed  Google Scholar 

  15. Saul JP, Cohen RJ. Respiratory sinus arrhythmia, vagal control of the heart rate: experimental basis and clinical implications. In: Levy MN, Schwartz PJ, editors. Heart rate variability, Chapter 30. Armonk: Futura Publishing Co; 1995.

    Google Scholar 

  16. Grossman P, Taylor EW. Toward understanding respiratory sinus arrhythmia: relations to cardia vagal tone, evolution and biobehavioral functions. Biol Psychol. 2007;74:263–85.

    PubMed  CrossRef  Google Scholar 

  17. Malliani A, Pagani M, Lombardi F, et al. Cardiovascular neural regulation explored in the frequency domain. Circulation. 1991;84:482–92.

    CAS  PubMed  CrossRef  Google Scholar 

  18. Bernstein AD, Parsonnet V. Survey of cardiac pacing and implanted defibrillator practice patterns in the United States in 1997. Pacing Clin Electrophysiol. 2001;24:842–55.

    CAS  PubMed  CrossRef  Google Scholar 

  19. Ector H, Rickards AF, Kappenberger L, Linde C, Vardas P, Oto A, Santini M, et al. The world survey of cardiac pacing and implantable cardioverter defibrillators: calendar year 1997. Europe. Pacing Clin Electrophysiol. 2001;24:863–8.

    CAS  PubMed  CrossRef  Google Scholar 

  20. Wolf PA, Mitchell JB, Baker CS, Kannel WB, D’Agostino RB. Impact of atrial fibrillation on mortality, stroke, and medical costs. Arch Intern Med. 1998;158:229–34.

    CAS  PubMed  CrossRef  Google Scholar 

  21. Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham heart study. Circulation. 1998;98:946–52.

    CAS  PubMed  CrossRef  Google Scholar 

  22. Wattigney WA, Mensah GA, Croft JB. Increasing trends in hospitalization for atrial fibrillation in the United States, 1985 through 1999: implications for primary prevention. Circulation. 2003;108:711–6.

    PubMed  CrossRef  Google Scholar 

  23. Glotzer TV, Hellkamp AS, Zimmerman J, Sweeney MO, Yee R, Marinchak R, Cook J, et al. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the atrial diagnostics ancillary study of the mode selection trial (MOST). Circulation. 2003;107:1614–9.

    PubMed  CrossRef  Google Scholar 

  24. Carlson MD, Ip J, Messenger J, Beau S, Kalbfleisch S, Gervais P, Cameron DA, et al. A new pacemaker algorithm for the treatment of atrial fibrillation: results of the atrial dynamic overdrive pacing trial (ADOPT). J Am Coll Cardiol. 2003;42:627–33.

    PubMed  CrossRef  Google Scholar 

  25. Lee MA, Weachter R, Pollak S, Kremers MS, Naik AM, Silverman R, Tuzi J, et al. The effect of atrial pacing therapies on atrial tachyarrhythmia burden and frequency: results of a randomized trial in patients with bradycardia and atrial tachyarrhythmias. J Am Coll Cardiol. 2003;41:1926–32.

    PubMed  CrossRef  Google Scholar 

  26. Israel CW, Lawo T, Lemke B, Gr ¨onefeld G, Hohnloser DH. Atrial pacing in the prevention of paroxysmal atrial fibrillation: first results of a new combined algorithm. Pacing Clin Electrophysiol. 2000;23:1888–90.

    CAS  PubMed  CrossRef  Google Scholar 

  27. Blanc JJ, De Roy L, Mansourati J, Poezevara Y, Marcon JL, Schoels W, Hidden-Lucet F, et al. Atrial pacing for prevention of atrial fibrillation: assessment of simultaneously implemented algorithms. Europace. 2004;6:371–9.

    PubMed  CrossRef  Google Scholar 

  28. Puglisi A, Favale S, Scipione P, Melissano D, Pavia L, Ascani F, Elia M, Scaccia A, Sagone A, Castaldi B, Musacchio E, Botto GL, Burden II Study Group. Overdrive versus conventional or closed-loop rate modulation pacing in the prevention of atrial tachyarrhythmias in brady-tachy syndrome. Pacing Clin Electrophysiol. 2008;31:1443–55.

    PubMed  CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Autonomic Laboratory Department of Cardiology, Drexel University College of Medicine, Philadelphia, PA, USA

    Joseph Colombo PhD

  2. ANSAR Medical Technologies, Inc., Philadelphia, PA, USA

    Joseph Colombo PhD

  3. Department of Medicine, Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA

    Rohit Arora MD, FACC, FAHA, FACP, FSCAI

  4. Department of Cardiology, The Chicago Medical School, North Chicago, IL, USA

    Rohit Arora MD, FACC, FAHA, FACP, FSCAI

  5. Department of Cardiology, Hahnemann Hospital Drexel University College of Medicine, Philadelphia, PA, USA

    Nicholas L. DePace MD, FACC

  6. Department of Medicine, Eastern Virginia Medical School Strelitz Diabetes Research Center, Norfolk, VA, USA

    Aaron I. Vinik MD, PhD, FCP, MACP

Authors
  1. Joseph Colombo PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rohit Arora MD, FACC, FAHA, FACP, FSCAI
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicholas L. DePace MD, FACC
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aaron I. Vinik MD, PhD, FCP, MACP
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Colombo, J., Arora, R., DePace, N.L., Vinik, A.I. (2015). Arrhythmia. In: Clinical Autonomic Dysfunction. Springer, Cham. https://doi.org/10.1007/978-3-319-07371-2_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-07371-2_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07370-5

  • Online ISBN: 978-3-319-07371-2

  • eBook Packages: MedicineMedicine (R0)