Related Experiment Video

Updated: Apr 21, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

2.3K

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
PubMed

Insights

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.
Abstract

Keywords:
Atrial fibrillationCardiac autonomic functionHeart rate variabilityPeriodic repolarization dynamics

More Related Videos

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

34.4K
Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice08:05

Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice

Published on: June 29, 2022

3.8K

Related Concept Videos

Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
349
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
376
Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
650
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
336
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
365
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.5K