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Iwakoshi H, Asada YC, Nakata M, Makino M, Munakata J, Tomura N, Shimoo S, Nishimura T, Shiraishi H, Matoba S, Senoo K. Impact of Sleep Apnea on Nocturnal Parasympathetic Activity in Atrial Fibrillation Patients After Catheter Ablation - Implications for Heart Rate Variability Analysis. Circ J 2024; 88:1081-1088. [PMID: 38281763 DOI: 10.1253/circj.cj-23-0682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
BACKGROUND The impact of sleep apnea (SA) on heart rate variability (HRV) in atrial fibrillation (AF) patients has not been investigated.Methods and Results: Of 94 patients who underwent AF ablation between January 2021 and September 2022, 76 patients who had a nocturnal Holter electrocardiography and polysomnography conducted simultaneously were included in the analysis. A 15-min duration of HRV, as determined by an electrocardiogram during apnea and non-apnea time, were compared between patients with and without AF recurrence at 12 months' postoperatively. Patients had a mean age of 63.4±11.6 years, 14 were female, and 20 had AF recurrence at 12 months' follow-up. The root mean square of the difference between consecutive normal-to-normal intervals (RMSSD, ms) an indicator of a parasympathetic nervous system, was more highly increased in patients with AF recurrence than those without, during both apnea and non-apnea time (apnea time: 16.7±4.5 vs. 13.5±3.3, P=0.03; non-apnea time: 20.9±9.5 vs. 15.5±5.9, P<0.01). However, RMSSD during an apneic state was decreased more than that in a non-apneic state in both groups of patients with and without AF recurrence (AF recurrence group: 16.7±4.5 vs. 20.9±9.5, P<0.01; non-AF recurrence group; 13.5±3.3 vs. 15.5±5.9, P=0.03). Consequently, the effect of AF recurrence on parasympathetic activity was offset by SA. Similar trends were observed for other parasympathetic activity indices; high frequency (HF), logarithm of HF (lnHF) and the percentage of normal-to-normal intervals >50 ms (pNN50). CONCLUSIONS Without considering the influence of SA, the results of nocturnal HRV analysis might be misinterpreted. Caution should be taken when using nocturnal HRV as a predictor of AF recurrence.
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Affiliation(s)
- Hibiki Iwakoshi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Yusuke C Asada
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Mitsuko Nakata
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Masahiro Makino
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Jun Munakata
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Nobunari Tomura
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Satoshi Shimoo
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Tetsuro Nishimura
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Hirokazu Shiraishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
- Department of Cardiac Arrhythmia Research and Innovation, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Keitaro Senoo
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
- Department of Cardiac Arrhythmia Research and Innovation, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
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Cruz AÂS, Wanner SP, Stieler E, Romão J, Esteves AM, Andrade HDA, Lôbo ILB, Amaral AS, Rabelo PCR, de Mello MT, Silva A. Cardiac autonomic nervous activity during different sleep stages in individuals with spinal cord injury: The influence of physical training. Sleep Med 2024; 117:25-32. [PMID: 38503197 DOI: 10.1016/j.sleep.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/29/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE The present study assessed the influence of physical training on cardiac autonomic activity in individuals with spinal cord injury (SCI) during different sleep stages. METHODS Twenty-six volunteers were allocated into three groups: 9 sedentary individuals without SCI (control, CON); 8 sedentary tetraplegic individuals with chronic SCI (SED-SCI); 9 physically trained tetraplegic individuals with chronic SCI (TR-SCI). All participants underwent nocturnal polysomnography to monitor sleep stages: wakefulness, non-rapid eye movement (NREM) sleep (N1, N2, and N3 stages), and REM sleep. The electrocardiography data obtained during this exam were extracted to analyze the heart rate variability (HRV). RESULTS Sleep stages influenced HRV in the time [RR interval and root mean square of successive RR interval differences (RMSSD)] and frequency [low-frequency (LF) and high-frequency (HF) powers and LF-to-HF ratio] domains (P < 0.05). SED-SCI individuals showed unchanged HRV compared to CON (P > 0.05). When comparing the TR-SCI and SED-SCI groups, no significant differences in HRV were reported in the time domain (P > 0.05). However, in the frequency domain, more accentuated HF power was observed in TR-SCI than in SED-SCI individuals during the N2 and N3 stages and REM sleep (P < 0.05). Moreover, TR-SCI had higher HF power than CON during the N3 stage (P < 0.05). CONCLUSIONS TR-SCI individuals have greater HF power, indicative of parasympathetic modulation, than sedentary (injured or not injured) individuals during different sleep stages. Therefore, enhanced parasympathetic activity induced by physical training may improve cardiac autonomic modulation during sleep in individuals with chronic SCI.
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Affiliation(s)
- Aline Ângela Silva Cruz
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Samuel Penna Wanner
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Eduardo Stieler
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Júlia Romão
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Andrea Maculano Esteves
- Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, R. Pedro Zaccaria, 1300, Jardim Santa Luiza, Limeira, SP, Brazil
| | - Henrique de Araújo Andrade
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Ingrid Ludimila Bastos Lôbo
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Adriana Souza Amaral
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Patrícia Conceição Rocha Rabelo
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Marco Túlio de Mello
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Andressa Silva
- Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil.
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Millet GP, Chamari K. Look to the stars-Is there anything that public health and rehabilitation can learn from elite sports? Front Sports Act Living 2023; 4:1072154. [PMID: 36755563 PMCID: PMC9900137 DOI: 10.3389/fspor.2022.1072154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/01/2022] [Indexed: 01/24/2023] Open
Affiliation(s)
- Grégoire P. Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland,Correspondence: Grégoire P. Millet
| | - Karim Chamari
- Aspetar, Orthopedic and Sports Medicine Hospital, FIFA Medical Center of Excellence, Doha, Qatar
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