[Assessment of autonomic nervous activity before the onset of paroxysmal atrial fibrillation]

Abstract

Autonomic nervous activity is involved in the onset of paroxysmal atrial fibrillation, but it is not clear how the sympathetic and parasympathetic nervous systems interact before the onset of atrial fibrillation. Twelve lone atrial fibrillation patients and 10 healthy volunteers were studied using 24-hour Holter electrocardiography monitoring. A total of 17 episodes were analyzed. Autonomic nervous activity was assessed based on the high frequency power (HF) spectrum (HF represents parasympathetic nervous activity) and the ratio to the low frequency power (LF) spectrum (L/H represents sympathetic nervous activity) of heart rate variability during sinus rhythm, and the 24-hour averaged autonomic indices were compared between atrial fibrillation patients and healthy volunteers. Comparative data were obtained 30, 20, 10, and 2 min before the onset of atrial fibrillation for each episode. There were no significant differences in the HF and L/H ratio between the patients and healthy volunteers. There were no significant differences in the HF values before the onset of paroxysmal atrial fibrillation, but the L/H ratio before the onset of atrial fibrillation at 30, 20 and 10 min was 1.03 +/- 0.42, 0.95 +/- 0.50, and 1.32 +/- 0.46, respectively, and just before the episode was 1.73 +/- 0.73, so the Spearman's rank correlation coefficient was 0.43. Basal autonomic nervous activity in patients with paroxysmal atrial fibrillation showed no changes compared with healthy volunteers. Sympathetic nervous activity increased progressively from about 30 min before the onset of atrial fibrillation, but parasympathetic nervous activity showed no significant changes. Therefore, a transient augmentation of sympathetic tone may be important in the onset of atrial fibrillation.