The Relationship Between Heart Rate Variability Parameters and Atrioventricular Nodal Reentrant Tachycardia

Abstract

Introduction: Heart rate variability (HRV) is associated with sympathetic tone. Studies have disputed the interpretation of the low frequency (LF) and low/high frequency (LF/HF) ratio for the indication of sympathetic cardiac control and autonomic balance. This study aims to investigate the association between HRV parameters and atrioventricular nodal reentrant tachycardia (AVNRT) and observe the effect of autonomic nervous system on AVNRT.

Patients and Methods: In total, 354 subjects with palpitations underwent the electrophysiological study (EPS). Most (71%; 253/354) patients had at least an ambulatory Holter ECG recording of 24 h. As a consequence of the exclusion criteria, 160 individuals were classified into two groups: control group (no arrhythmia induced, n= 90) and AVNRT group (n= 70).

Results: Daytime and nighttime LF and LF/HF ratio were significantly higher in the AVNRT group (p< 0.05) than in the control group. Interestingly, daytime ultra-LF, very LF, and total power were significantly lower in the AVNRT group.

Conclusion: AVNRT is associated with altered sympathovagal balance. Furthermore, increased LF and LF/HF may be indicative of enhanced sympathetic activity in patients with AVNRT because of inhomogeneous ventricular activation via the slow accessory pathway.

Keywords

• Atrioventricular nodal reentrant tachycardia,heart rate variability,low frequency,low/high frequency

Kalp Hızı Değişkenliği Parametreleri ile Atriyoventriküler Nodal Reentrant Taşikardi Arasındaki İlişki

Abstract

Giriş: Kalp hızı değişkenliği (HRV) sempatik ton ile ilişkilidir. Çalışmalar sempatik kardiyak kontrol ve otonom denge endikasyonu için düşük frekans (LF) ve düşük/yüksek frekans (LF/HF) oranının yorumlamasını tartışmışlardır. Bu çalışma, HRV parametreleri ile atriyoventriküler nodal reentrant taşikardi (AVNRT) arasındaki ilişkiyi araştırmayı ve otonomik sinir sisteminin AVNRT üzerindeki etkisini gözlemeyi amaçlamaktadır.

Hastalar ve Yöntem: Çarpıntısı olan 354 olguya elektrofizyolojik çalışma yapıldı (EPS). Hastaların %71 (253/354)'i en az bir 24 saatlik ambulatuvar Holter elektrokardiyografi (EKG) kaydına sahipti. Dışlama kriterlerinin bir sonucu olarak, 160 birey iki gruba ayrıldı; kontrol grubu (aritmi indüklenmedi, n= 90) ve AVNRT grubu (n= 70).

Bulgular: Gündüz ve gece LF ve LF/HF oranı AVNRT'de kontrollerden anlamlı derecede yüksekti (p< 0.05). İlginç olarak, gündüz ultra düşük frekans, çok düşük frekans ve toplam güç AVNRT’de anlamlı olarak düşüktü.

Sonuç: AVNRT değişmiş sempatovagal denge ile ilişkilidir. Dahası, artmış LF ve LF/HF, AVNRT hastalarında yavaş aksesuar yolla homojen olmayan ventriküler aktivasyonun bir sonucu olarak artmış sempatik aktivitenin bir göstergesi olabilir.

Keywords

• Atriyoventriküler nodal reentrant taşikardi,kalp hızı değişkenliği,düşük frekans,düşük/yüksek frekans

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