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Updated: Apr 21, 2026
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
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Cardiac autonomic function in elderly patients with and without atrial fibrillation
Peter Hämmerle1, Johannes Schier1, Konstantinos D Rizas2,3
1Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.
European Heart Journal Open
|April 20, 2026
Summary
Atrial fibrillation (AF) is linked to increased sympathetic activity, particularly during AF episodes. Periodic repolarization dynamics (PRD) may help assess cardiac autonomic function in AF patients.
Area of Science:
- Cardiology
- Autonomic Nervous System Research
- Medical Diagnostics
Background:
- Cardiac autonomic dysfunction is a known predictor of poor outcomes in atrial fibrillation (AF) patients.
- The direct relationship between AF and cardiac autonomic function (CAF) requires further clarification.
- Heart rate variability (HRV) is a key indicator for assessing CAF.
Purpose of the Study:
- To investigate differences in CAF, measured by HRV, between patients with and without AF.
- To determine if AF itself is associated with altered CAF.
- To explore the utility of periodic repolarization dynamics (PRD) in assessing CAF in AF.
Main Methods:
- Prospective enrollment of 2289 patients from the Swiss-AF multicentre study.
- Collected 5-minute resting ECG recordings during sinus rhythm (SR) or AF.
- Quantified CAF using PRD (sympathetic activity marker) and conventional HRV parameters.
Main Results:
- Median PRD was significantly higher in patients with AF (AF-AF: 7.0 deg) compared to those in SR (SR: 4.8 deg) and AF patients with SR ECGs (AF-SR: 5.1 deg).
- The AF-AF group exhibited a stronger association with elevated PRD (β=2.10, P<0.001) than the AF-SR group (β=0.36, P=0.011) versus the SR group.
- Other HRV parameters suggested greater autonomic impairment in the AF-SR group compared to the SR group.
Conclusions:
- Atrial fibrillation is associated with heightened sympathetic activity.
- The most significant impairment in CAF was observed in patients experiencing AF.
- PRD shows potential as a valuable tool for CAF assessment in AF patients.
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