Evaluation of autonomic nervous function during upper gastrointestinal endoscopy using heart rate variability

Area of Science:

• Cardiology
• Autonomic Nervous System Function

Background:

• Upper gastrointestinal endoscopy is a common procedure.
• Autonomic nervous system (ANS) function can be affected during medical procedures.
• Assessing ANS function may help predict complications.

Purpose of the Study:

• To investigate changes in autonomic nervous function during upper gastrointestinal endoscopy.
• To determine if autonomic imbalance influences arrhythmia generation during endoscopy.
• To identify predictors of cardiovascular complications related to endoscopy.

Main Methods:

• Analyzed R-R interval variability from electrocardiograms using time- and frequency-domain analyses.
• Recorded Holter electrocardiograms before, during, and after endoscopy.
• Compared heart rate variability parameters between groups premedicated with scopolamine butylbromide and glucagon, and between subjects with and without arrhythmias.

Main Results:

• High frequency spectral power (HF power), reflecting parasympathetic activity, significantly decreased after premedication and further during endoscopy in the scopolamine butylbromide group.
• Subjects with arrhythmias (A group) exhibited significantly lower HF power before premedication and during endoscopy compared to subjects without arrhythmias (N group).

Conclusions:

• Measurement of HF power before endoscopy can identify individuals with reduced parasympathetic activity.
• Identifying subjects with reduced HF power may allow for the prevention of cardiovascular complications associated with premedication and endoscope insertion.