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Cardiac Autonomic Dysfunction and Incidence of Atrial Fibrillation: Results From 20 Years Follow-Up.

TitleCardiac Autonomic Dysfunction and Incidence of Atrial Fibrillation: Results From 20 Years Follow-Up.
Publication TypeJournal Article
Year of Publication2017
AuthorsAgarwal SK, Norby FL, Whitsel EA, Soliman EZ, Chen LYee, Loehr LR, Fuster V, Heiss G, Coresh JJ
Secondary AuthorsAlonso A
JournalJ Am Coll Cardiol
Volume69
Issue3
Pagination291-299
Date Published2017 Jan 24
ISSN1558-3597
KeywordsAdult, Atrial Fibrillation, Autonomic Nervous System Diseases, Electrocardiography, Female, Follow-Up Studies, Heart Diseases, Heart Rate, Humans, Male, Middle Aged
Abstract

BACKGROUND: Cardiac autonomic perturbations frequently antecede onset of paroxysmal atrial fibrillation (AF). Interventions that influence autonomic inputs to myocardium may prevent AF. However, whether low heart rate or heart rate variability (HRV), which are noninvasive measures of cardiac autonomic dysfunction, are associated with AF incidence is unclear.

OBJECTIVES: This study sought to study the association between HRV and risk of AF.

METHODS: This study included 11,715 middle-aged adults in the ARIC (Atherosclerosis Risk In Communities) cohort with heart rate and HRV measures obtained from 2-min electrocardiogram recordings performed at baseline (1987 to 1989). These measures included SD of normal-to-normal RR intervals, high-frequency (HF) (0.15 to 0.40 Hz), low-frequency (0.04 to 0.15 Hz), and the low-frequency/HF ratio (denoting a greater sympathetic to parasympathetic dominance). Incident AF cases were ascertained by electrocardiogram at ARIC follow-up visits, hospital discharge diagnosis, or death certificates through 2011.

RESULTS: During an average follow-up of 19.4 years, 1,580 or 13.5% of participants developed AF. A baseline heart rate 

CONCLUSIONS: Cardiac autonomic dysfunction denoted by low resting short-term HRV was associated with higher AF incidence. A low heart rate may be associated with higher AF risk. Further studies are needed to determine whether interventions in the general population to restore autonomic balance may prevent AF.

DOI10.1016/j.jacc.2016.10.059
Alternate JournalJ Am Coll Cardiol
PubMed ID28104071
PubMed Central IDPMC5260487
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
16EIA26410001 / AHA / American Heart Association-American Stroke Association / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
RC1 HL099452 / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States