Premium
Autonomic Function during Closed Loop Stimulation and Fixed Rate Pacing: Heart Rate Variability Analysis from 24‐Hour Holter Recordings
Author(s) -
QUAGLIONE RAFFAELE,
CALCAGNINI GIOVANNI,
CENSI FEDERICA,
PICCIRILLI FABRIZIO,
IANNUCCI LUCA,
RAVEGGI MARCO,
BIANCALANA GIANLUCA,
BARTOLINI PIETRO
Publication year - 2010
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2009.02615.x
Subject(s) - medicine , cls upper limits , heart rate variability , cardiology , heart rate , electrocardiography , balance (ability) , autonomic function , autonomic nervous system , anesthesia , blood pressure , physical therapy , optometry
Aim: Aim of this retrospective study was to analyze the effect of closed‐loop stimulation (CLS) and DDD pacing mode on autonomic balance, and to evaluate heart rate variability (HRV) during CLS stimulation.Methods and Materials: Autonomic balance was estimated by a 24‐hour HRV analysis of paced and spontaneous beats in patients implanted with a dual‐chamber pacemaker (Inos 2+ CLS—Biotronik GmbH, Berlin, Germany) and randomly assigned to CLS or DDD pacing mode. Patients underwent two 24‐hour electrocardiogram Holter recordings at the end of each 3‐month pacing mode period. Each Holter recording was automatically scanned to extract sequences of consecutive beats of the same type [atrial paced (Ap)‐sequence and atrial spontaneous (As)‐sequence], lasting at least 130 beats.Results: Eight hundred and ten sequences were extracted from 15 patients, and the following spectral parameters were evaluated during both CLS and DDD mode: the total power (variance), the absolute and percentage (relative to the total power) powers of the low frequency (LF, 0.04–0.15 Hz) and high frequency (HF, 0.15–0.4 Hz) components, as well as the LF/HF power ratio.Discussion: The two main findings of this study were: in all the patients, CLS seems to mimic short‐term physiological HRV, although the variability (total power) was lower than that relative to the spontaneous beats; the HRV of the spontaneous beats had an higher LF/HF when the pacemaker was programmed as DDD respect to CLS, consistent with a shift toward sympathetic predominance. PACE 2010; 33:337–342)