Dynamic behavior and autonomic regulation of ectopic atrial pacemakers

Heart rate (HR) variability reflects the neural regulation of normal pacemaker tissue, but the autonomic nervous regulation of abnormal atrial foci originating outside the sinus node has not been well characterized. We compared the HR variability of tachycardias originating from the ectopic foci and...

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Published in:Circulation (New York, N.Y.) N.Y.), 1999-09, Vol.100 (13), p.1416-1422
Main Authors: HUIKURI, H. V, POUTIAINEN, A.-M, MÄKIKALLIO, T. H, KOISTINEN, M. J, AIRAKSINEN, K. E. J, MITRANI, R. D, MYERBURG, R. J, CASTELLANOS, A
Format: Article
Language:English
Subjects:
Adult
Anti-Arrhythmia Agents - pharmacology
Atrial Function
Atropine - pharmacology
Autonomic Nervous System - physiopathology
Biological and medical sciences
Biological Clocks
Cardiac dysrhythmias
Cardiology. Vascular system
Child
Female
Heart
Heart Rate - drug effects
Humans
Injections, Intravenous
Male
Medical sciences
Middle Aged
Tachycardia - physiopathology
Time Factors
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Summary:Heart rate (HR) variability reflects the neural regulation of normal pacemaker tissue, but the autonomic nervous regulation of abnormal atrial foci originating outside the sinus node has not been well characterized. We compared the HR variability of tachycardias originating from the ectopic foci and the sinus node. R-R-interval variability was analyzed from 24-hour Holter recordings in 12 patients with incessant ectopic atrial tachycardia (average HR 107+/-14 bpm), 12 subjects with sinus tachycardia (average HR 106+/-9 bpm), and 24 age- and sex-matched subjects with normal sinus rhythm (average HR 72+/-8 bpm). Time- and frequency-domain HR variability measures, along with approximate entropy, short- and long-term correlation properties of R-R intervals (exponents alpha(1) and alpha(2)), and power-law scaling (exponent beta), were analyzed. Time- and frequency-domain measures of HR variability did not differ between subjects with ectopic and sinus tachycardia. Fractal scaling exponents and approximate entropy were similar in sinus tachycardia and normal sinus rhythm, but the short-term scaling exponent alpha(1) was significantly lower in ectopic atrial tachycardia (0.71+/-0.16) than in sinus tachycardia (1.16+/-0.13; P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.100.13.1416