Abnormal Nocturnal Heart Rate Variability and QT Dynamics in Patients with Brugada Syndrome

Pierre, Bertrand; Babuty, Dominique; Poret, Philippe; Giraudeau, C.; Marie, Olivier; Cosnay, P; Fauchier, Laurent

doi:10.1111/j.1540-8159.2007.00635.x

Cited by 15 publications

(17 citation statements)

References 10 publications

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“…It also has been shown that ST elevation increases after meals, especially dinner, in symptomatic patients 16 . The reports of bradycardia‐dependent episodes, the increased vagal tone in patients with VF, and the nocturnal predominance of the arrhythmic events support the hypothesis that the autonomic nervous system is involved in arrhythmogenesis 15–20 . The proposed mechanism is that bradycardia predisposes to increased current imbalance and extrasystoles, which may act at the vulnerable window for VT/VF.…”

Section: Discussionmentioning

confidence: 91%

Disorders of the Autonomic Nervous System in Patients With Brugada Syndrome: A Pilot Study

Κωστοπούλου

Koutelou

Theodorakis

et al. 2010

Cardiovasc electrophysiol

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Section: Discussionmentioning

confidence: 91%

Disorders of the Autonomic Nervous System in Patients With Brugada Syndrome: A Pilot Study

Κωστοπούλου

Koutelou

Theodorakis

et al. 2010

Cardiovasc electrophysiol

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“…Pierre et al [35] reported that 24-h ECG Holter of symptomatic Brugada patients were characterized by lower LF and HF components [6, 36], while other studies showed no differences in HRV between Brugada and healthy subjects, either during day or night [7]. When interpreting the contrasting results, several factors must be considered carefully: first, 24-h ECG Holter recordings do not differentiate between wake and sleep; second, comorbid (and often undiagnosed) SDB could potentially contribute to autonomic alterations; third, respiratory irregularities and apneas due to SDB would confound HRV measures; fourth, cardiovascular autonomic control is not stable during sleep, so it is essential to consider the different sleep stages.…”

Section: Discussionmentioning

confidence: 99%

Cardiac autonomic control in Brugada syndrome patients during sleep: The effects of sleep disordered breathing

Tobaldini

Brugada

Benito

et al. 2013

International Journal of Cardiology

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Aims Brugada syndrome is characterized by typical ECG features, ventricular arrhythmias and sudden cardiac death (SCD), more frequent during nighttime. Autonomic cardiovascular control has been implicated in triggering the ventricular arrhythmias. Sleep-disordered breathing (SDB) elicits marked autonomic changes during sleep and it is associated with an increased risk of nighttime SCD. Brugada patients may have a higher likelihood of SDB compared to controls. However, no data are available on cardiac autonomic control in Brugada patients, particularly with regard to the comorbidity of SDB. Methods We evaluated autonomic cardiovascular control in Brugada patients with SDB (BRU-SDB, n=9), without SDB (BRU, n= 9), in controls (CON, n=8) and in non-Brugada patients with SDB (n=6), during wakefulness and sleep (N2, N3 and REM). Linear spectral and entropy-derived measures of heart rate variability (HRV) were performed during apnea-free stable breathing epochs. Results Total HRV was attenuated in BRU-SDB compared to CON and BRU. During N2 and REM, in BRU-SDB patients sympathetic modulation decreased compared to BRU and CON, while during REM, they showed an increased parasympathetic modulation, compared to the other two groups. BRU-SDB and SDB were similar in terms of spectral components. Entropy-derived indices showed preserved dynamic changes in Brugada patients compared to controls through the different sleep stages. Conclusion Brugada syndrome per se does not appear associated with an altered autonomic cardiovascular control during wakefulness and sleep. The comorbidity with SDB may contribute to disrupted autonomic cardiovascular regulation during sleep, possibly predisposing to the increased likelihood of sleep-related ventricular tachyarrhythmias and SCD.

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“…55 In these patients SDNN 56 and LF power 57 of beating interval are reduced. A lack of sympathetic drive in the presence of sustained parasympathetic, drive together with a reduction in cAMP level (due to a direct feedback from a reduction in Na that decreases the Ca 2+ balance in the cell), were documented in patients with Brugada syndrome.…”

Section: Change In Hrv and Fractal-like Behavior In Cardiac Diseasesmentioning

confidence: 83%

Impaired Signaling Intrinsic to Sinoatrial Node Pacemaker Cells Affects Heart Rate Variability during Cardiac Disease

2014

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The normal heart beat intervals are neither strictly stationary nor completely random, and continuously shift from one period to another. Decoding the ECG identifies this “hidden” information that imparts inherent complexity to the heart-beating interval time series. Loss of this complexity in cardiovascular disease is manifested as a reduction in heart rate variability (HRV) and this reduction correlates with an increase in both morbidity and mortality. Because HRV measurements are noninvasive and easy to perform, they have emerged as an important tool in cardiology. However, the identities of specific mechanisms that underline the changes in HRV that occur in cardiovascular diseases remain largely unknown. Changes in HRV have mainly been interpreted on a neural basis, ie due to changes in autonomic impulses to the heart: sympathetic activity decreases both the average heart beat interval and HRV, and parasympathetic activity increases both. It has now become clear, however, that the heart rate and HRV are also determined by intrinsic properties of the pacemaker cells that comprise the sinoatrial node, and the responses of these properties to autonomic receptor stimulation. Here we review how changes in the properties of coupled-clock mechanisms intrinsic to pacemaker cells that comprise the sinoatrial node and their impaired response to autonomic receptor stimulation are implicated in the changes of HRV observed in heart diseases.

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Abnormal Nocturnal Heart Rate Variability and QT Dynamics in Patients with Brugada Syndrome

Cited by 15 publications

References 10 publications

Disorders of the Autonomic Nervous System in Patients With Brugada Syndrome: A Pilot Study

Disorders of the Autonomic Nervous System in Patients With Brugada Syndrome: A Pilot Study

Cardiac autonomic control in Brugada syndrome patients during sleep: The effects of sleep disordered breathing

Impaired Signaling Intrinsic to Sinoatrial Node Pacemaker Cells Affects Heart Rate Variability during Cardiac Disease

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