Open AccessRestoring Sinus Rhythm Improves Baroreflex Function in Patients With Persistent Atrial Fibrillation
Author(s) -
Field Michael E.,
Wasmund Stephen L.,
Page Richard L.,
Hamdan Mohamed H.
Publication year - 2016
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.115.002997
Subject(s) - medicine , atrial fibrillation , cardioversion , sinus rhythm , baroreflex , cardiology , ejection fraction , anesthesia , heart failure , heart rate , blood pressure
Background Studies have suggested that patients with atrial fibrillation ( AF ) have impairment in the baroreflex. It is not clear whether these findings are the result of the associated comorbid conditions or the arrhythmia itself. We hypothesized that AF is associated with impairment in baroreflex function and that the arrhythmia itself is a contributing factor. Methods and Results Twenty‐four patients with persistent AF referred for cardioversion were enrolled. A second group of patients with no history of AF matched for age and left ventricular ejection fraction was identified and served as the control group. In the AF group, baroreflex gain ( BRG ) was measured on the day of cardioversion (Day 1) and again at 30 days post‐cardioversion (Day 30) in patients who remained in sinus rhythm ( SR ). The clinical characteristics of patients with AF were not different than those of the control group. The mean BRG in the AF group on Day 1 was significantly lower than the mean BRG of the control group (5.2±3.6 versus 10.8±5.5 ms/mm Hg, P <0.05). Ten patients experienced AF recurrence before the 30‐day follow‐up and 14 patients remained in SR . In the group that remained in SR , BRG increased from 4.1±3.7 ms/mm Hg on Day 1 to 7.0±6.0 ms/mm Hg on Day 30 ( P <0.01). Conclusion We have shown that AF is associated with impairment of the baroreflex and that restoration of SR improves BRG . Our data suggest that AF might be a contributing factor to the observed impairment in BRG and that restoring SR might help improve baroreflex function.