Asymptomatic versus symptomatic episodes in patientswith paroxysmal atrial fibrillation via long-term monitoring with implantable loop recorders.

作者：Simantirakis E N^*; Papakonstantinou P E; Chlouverakis G I; Kanoupakis E M; Mavrakis H E; Kallergis E M; Arkolaki E G; Vardas P E

来源：International Journal of Cardiology, 2017, 231: 125-130.

DOI：10.1016/j.ijcard.2016.12.025

• Atrial fibrillation
• Autonomic nervous system
• Implantable loop recorder
• Heart rate variability
• ECG

Background: The presentation of atrial fibrillation (AF) varies remarkably, from totally asymptomatic to symptomatic patients, while the same individual may present symptomatic and asymptomatic episodes. We aimed to identify electrocardiographic differences between symptomatic and asymptomatic episodes and to find parameters related to the appearance of symptoms.
Methods: Thirty consecutive patients (age 66.9 +/- 10 years) with paroxysmal AF received an implantable loop recorder. Three types of episodeswere defined: asymptomatic (ASx), symptomatic (Sx), andmixed asymptomatic symptomatic (AS-Sx). The heart rate (HR) and heart rate variability (HRV) were recorded during the first 2 min of each ASx or Sx episode, and during the first 2 min of both the symptomatic and asymptomatic periods in AS-Sx.
Results: Eighty-two episodes fromtwenty-five patientswere evaluated. Mean HRwas 142.48 +/- 25.84 bpm for Sx and 95.71 +/- 19.29 bpm for ASx (p < 0.001). Mean HRV was 92.62 +/- 42.29 ms for Sx and 150.06 +/- 49.68 ms for ASx (p < 0.001). In AS- Sx, mean HRwas 102.91 +/- 24.54 bpm for the asymptomatic and 141.88 +/- 23.43 bpmfor the symptomatic period (p < 0.001). Mean HRV was 173.55 +/- 61.30 ms for the asymptomatic and 87.33 +/- 30.65ms for the symptomatic period (p = 0.003). Therewere no significant correlations between patients' characteristics and the clinical presentation of the arrhythmia.
Conclusions: The ASx were characterized by a lowerHR and higher HRV compared to Sx. In As- Sx, the asymptomatic period was characterized by a lower HR and higher HRV compared to the symptomatic. These findings suggest a possible contribution of variations in the autonomic nervous system activity to the perception of the arrhythmia. c 2016 Elsevier Ireland Ltd.

• 出版日期2017-3-15