Imperial College London
Alternate

Professor Stuart D Rosen

Faculty of Medicine, National Heart & Lung Institute

Professor of Practice (Cardiology)
 
 
 
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Contact

 

+44 (0)20 8967 5359stuart.rosen Website

 
 
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Location

 

Ealing HospitalEaling Hospital

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Summary

 

Publications

Citation

BibTex format

@article{Patel:2018:10.1111/anec.12511,
author = {Patel, HC and Hayward, C and Wardle, AJ and Middleton, L and Lyon, AR and Di, Mario C and Salukhe, TV and Sutton, R and Rosen, SD},
doi = {10.1111/anec.12511},
journal = {Annals of Noninvasive Electrocardiology},
title = {The effect of head-up tilt upon markers of heart rate variability in patients with atrial fibrillation},
url = {http://dx.doi.org/10.1111/anec.12511},
volume = {23},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Heart rate variability (HRV) analysis is uncommonly undertaken in patients with atrial fibrillation (AF) due to an assumption that ventricular response is random. We sought to determine the effects of head-up tilt (HUT), a stimulus known to elicit an autonomic response, on HRV in patients with AF; we contrasted the findings with those of patients in sinus rhythm (SR). METHODS: Consecutive, clinically indicated tilt tests were examined for 207 patients: 176 in SR, 31 in AF. Patients in AF were compared to an age-matched SR cohort (n = 69). Five minute windows immediately before and after tilting were analyzed using time-domain, frequency-domain and nonlinear HRV parameters. Continuous, noninvasive assessment of blood pressure, heart rate and stroke volume were available in the majority of patients. RESULTS: There were significant differences at baseline in all HRV parameters between AF and age matched SR. HUT produced significant hemodynamic changes, regardless of cardiac rhythm. Coincident with these hemodynamic changes, patients in AF had a significant increase in median [quartile 1, 2] DFA-α2 (+0.14 [-0.03, 0.32], p < .005) and a decrease in sample entropy (-0.17 [-0.50, -0.01], p < .005). CONCLUSION: In the SR cohort, increasing age was associated with fewer HRV changes on tilting. Patients with AF had blunted HRV responses to tilting, mirroring those seen in an age matched SR group. It is feasible to measure HRV in patients with AF and the changes observed on HUT are comparable to those seen in patients in sinus rhythm.
AU  - Patel,HC
AU  - Hayward,C
AU  - Wardle,AJ
AU  - Middleton,L
AU  - Lyon,AR
AU  - Di,Mario C
AU  - Salukhe,TV
AU  - Sutton,R
AU  - Rosen,SD
DO  - 10.1111/anec.12511
PY  - 2018///
SN  - 1082-720X
TI  - The effect of head-up tilt upon markers of heart rate variability in patients with atrial fibrillation
T2  - Annals of Noninvasive Electrocardiology
UR  - http://dx.doi.org/10.1111/anec.12511
UR  - http://hdl.handle.net/10044/1/52174
VL  - 23
ER  -
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