scholarly journals Skin Sympathetic Nerve Activity and Rate Control of Atrial Fibrillation

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Anthony Douglas II ◽  
Takashi Kusayama, MD, PhD ◽  
Peng Sheng Chen, M.D
Keyword(s):  
Atrial Fibrillation ◽  
Beta Blocker ◽  
Rate Control ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Ventricular Rate ◽  
Strong Correlations ◽  
Nerve Activity ◽  
Blocker Therapy ◽  
Beta Blocker Therapy

Background and Hypothesis  Lifetime risks for atrial fibrillation (AF) are 1 in 4 for people 40 years of age and older. Rate and rhythm control are both important strategies in managing patients with AF. However, not all patients respond to beta blocker therapy. We hypothesize that sympathetic tone is important in rate control of AF, but the importance varied among patients.  Experimental Design or Project Methods  neuECG is a new noninvasive method to record skin sympathetic nerve activity (SKNA) and electrocardiogram. The present research recruited and recorded 2 paroxysmal and 3 persistent AF patients for 24 hours using neuECG. The average voltage of SKNA (aSKNA) and ventricular rate during AF was analyzed in one-min windows.  Results  The preliminary data reveal strong correlations (r=.783, r=.640, respectively, p<0.0001 for both) between aSKNA (1.19 ± 0.21 µV) and ventricular rate (110 ± 8 bpm) in the paroxysmal AF. High correlations were consistently observed when data were analyzed on an hourly basis. In comparison, strong correlations were found between aSKNA (1.13 ± 0.2 µV) and ventricular rate (88 ± 8.6 bpm) in persistent AF (r=.496, r= .796, r=.636 respectively, p<0.001 for both cases). However, hourly correlations displayed much higher variability between aSKNA and ventricular rate than that observed for paroxysmal AF.   Conclusion and Potential Impact.  aSKNA positively correlates with ventricular rate during AF. This relationship is stronger and more consistent during paroxysmal than persistent AF. These findings may be important in determining the efficacy of beta blocker therapy in rate control of AF. 

scholarly journals Skin sympathetic nerve activity and ventricular rate control during atrial fibrillation

Heart Rhythm ◽  
2020 ◽  
Vol 17 (4) ◽  
pp. 544-552 ◽  
Author(s):  
Takashi Kusayama ◽  
Anthony Douglas ◽  
Juyi Wan ◽  
Anisiia Doytchinova ◽  
Johnson Wong ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Rate Control ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Ventricular Rate ◽  
Nerve Activity ◽  
Skin Sympathetic Nerve Activity

Achieving ventricular rate control in patients taking chronic beta-blocker therapy

2018 ◽  
Vol 36 (1) ◽  
pp. 110-113 ◽  
Author(s):  
Megan E. Feeney ◽  
Sandra L.B. Rowe ◽  
Nathan D. Mah ◽  
Cassie A. Barton ◽  
Ran Ran
Keyword(s):  
Beta Blocker ◽  
Rate Control ◽  
Ventricular Rate ◽  
Blocker Therapy ◽  
Beta Blocker Therapy

P3517Failure to achieve adequate heart rate control in women during therapy optimization

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Kutyifa ◽  
J W Erath ◽  
A Burch ◽  
B Assmus ◽  
D Bondermann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Beta Blocker ◽  
Rate Control ◽  
Beta Blockers ◽  
Heart Rate Control ◽  
Blocker Therapy ◽  
Cardioverter Defibrillator ◽  
Beta Blocker Therapy ◽  
The Mean

Abstract Background Previous studies highlighted the importance of adequate heart rate control in heart failure patients, and suggested under-treatment with beta-blockers especially in women. However, data on women achieving effective heart rate control during beta-blocker therapy optimization are lacking. Methods The wearable cardioverter defibrillator (WCD) allows continuous monitoring of heart rate (HR) trends during WCD use. In the current study, we assessed resting HR trends (nighttime: midnight-7am) in women, both at the beginning of WCD use and at the end of WCD use to assess the adequacy of beta-blockade following a typical 3 months of therapy optimization with beta-blockers. An adequate heart rate control was defined as having a nighttime HR <70 bpm at the end of the 3 months. Results There were a total of 21,453 women with at least 30 days of WCD use (>140 hours WCD use on the first and last week). The mean age was 67 years (IQR 58–75). The mean nighttime heart rate was 72 bpm (IQR 65–81) at the beginning of WCD use, that decreased to 68 bpm (IQR 61–76) at the end of WCD use with therapy optimization. Women had an insufficient heart rate control with resting heart rate ≥70 bpm in 59% at the beginning of WCD use that decreased to 44% at the end of WCD use, but still remained surprisingly high. Interestingly, there were 21% of the women starting with HR ≥70 bpm at the beginning of use (BOU) who achieved adequate heart rate control by the end of use (EOU). Interestingly, 6% of women with adequate heart rate control at the start of therapy optimization ended up having higher heart rates >70 bpm at the end of the therapy optimization time period (Figure). Figure 1 Conclusions A significant proportion of women with heart failure and low ejection fraction do not reach an adequate heart rate control during the time of beta blocker initiation/titration. The wearble cardioverter defibrillator is a monitoring device that has been demonstrated in this study to appropriately identify patients with inadequate heart rate control at the end of the therapy optimization period. The WCD could be utilized to improve management of beta-blocker therapy in women and improve the achievement of adequate heart rate control in women.

scholarly journals Sympathetic Nerve Activity Efferent Drive and Beta-Blocker Treatment　– Effect of Interaction in Systolic Heart Failure –

2016 ◽  
Vol 80 (10) ◽  
pp. 2149-2154 ◽  
Author(s):  
Shuji Joho ◽  
Takashi Akabane ◽  
Ryuichi Ushijima ◽  
Tadakazu Hirai ◽  
Koichiro Kinugawa
Keyword(s):  
Heart Failure ◽  
Beta Blocker ◽  
Treatment Effect ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Systolic Heart Failure ◽  
Nerve Activity

Abstract 16096: Successful Pulmonary Vein Isolation Improve Diastolic Dysfunction and Sympathetic Nerve Activity in Atrial Fibrillation Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yusuke Mukai ◽  
Hisayoshi Murai ◽  
Tadayuki Hirai ◽  
Takuto Hamaoka ◽  
Yoshitaka Okabe ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Diastolic Dysfunction ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Muscle Sympathetic Nerve Activity ◽  
Left Ventricular ◽  
High Rate ◽  
Reverse Remodeling ◽  
Nerve Activity ◽  
Acceleration Rate

Introduction: Atrial fibrillation (AF) is associated with diastolic dysfunction (DD) at a high rate and the presence of left ventricular DD is also associated with increased muscle sympathetic nerve activity (MSNA). Catheter ablation (CA) of AF was reported to improve cardiac function, including the reverse remodeling of left ventricle and atrium. However, little is known about the effect of CA on MSNA and DD in AF patients. Purpose: The purpose of this study was to evaluate the effect of CA on MSNA and DD and the difference in therapeutic effect between two groups with and without DD. Methods: This study was conducted as a prospective, observational study. AF patients who were scheduled for CA were enrolled. The patients were divided into two groups, E/e’ ratio≧11 and <11. We measured blood pressure, HR, body weight, echocardiogram parameters, and MSNA before and 12 weeks after CA. Results: 28 AF patients participated in this study. After CA, in the patients with DD(the group of E/e’≧11, n=12), E/e’ ratio, the MSNA burst incidence(BI) and frequency(BF) were significantly decreased (13.4±2.1 to 10.6±3.0, p<0.01. 64.4±15.8 to 34.0±12.0 bursts/100beats, P<0.01, 39.7±9.3 to 23.5±9.2 bursts/min, p<0.01 respectively). In the patients without DD (the group of E/e’<11, n=16), the BI and BF were significantly decreased (59.7±11.8 to 43.5±11.7 bursts/100beats, P<0.01, 38.1±10.5 to 29.2±8.4 bursts/min, p<0.01 respectively) while there was no difference in E/e’ ratio. Interestingly, in the patients with DD, decrease in BI and BF were more pronounced compared in the patients without DD(-30.4±15.9 to -16.2±11.5 bursts/100beats, P<0.05. -16.3±11.5 to -8.9±13.8 bursts/min, P=0.145 respectively). In both groups, no significant changes were observed in EF and peak acceleration rate of mitral E velocity. Conclusion: CA reduced MSNA in AF patients. In the patients with DD, the reduction of MSNA tended to be more remarkable than without DD. These findings suggest that changes of MSNA might reflect the improvement of DD and reduction of AF burden.

beta-Blocker Therapy in Atrial Fibrillation

2003 ◽  
Vol 26 (7p2) ◽  
pp. 1607-1612 ◽  
Author(s):  
GERIAN C. GRONEFELD ◽  
STEFAN H. HOHNLOSER
Keyword(s):  
Atrial Fibrillation ◽  
Beta Blocker ◽  
Blocker Therapy ◽  
Beta Blocker Therapy
Sign in / Sign up

Export Citation Format

Share Document