Diurnal variations of the dominant cycle length of chronic atrial fibrillation

Am J Physiol Heart Circ Physiol. 2001 Jan;280(1):H401-6. doi: 10.1152/ajpheart.2001.280.1.H401.

Abstract

High-resolution digital Holter recording was carried out in 21 patients (15 men, 64 +/- 12 yr) with chronic atrial fibrillation. Dominating atrial cycle length (DACL) was derived by frequency domain analysis of QRST-reduced electrocardiograms. Daytime mean DACL was 150 +/- 17 ms, and nighttime mean was 157 +/- 22 ms (P = 0. 0002). Diurnal fluctuation in DACL differed among patients: it tended to be virtually absent in those with a short mean DACL, but in those with longer DACL the night-day difference was as much as 23 ms (R = 0.72, P < 0.001, correlation of mean DACL to night-day difference). Mean DACL also correlated with ventricular cycle length (R = 0.40, P < 0.001), particularly at night (r = 0.49). The shorter cycle lengths found in this study during the day are consistent with sympathetic and/or other physiological modulation, but since increased vagal tone shortens atrial refractoriness in most models, parasympathetic influences are not likely to play a major role. Alternatively, atrial effective refractory period may not be the sole determinant of atrial cycle length during atrial fibrillation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Atrial Fibrillation / physiopathology*
  • Chronic Disease
  • Circadian Rhythm*
  • Electrocardiography, Ambulatory
  • Female
  • Heart / physiopathology*
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Signal Processing, Computer-Assisted