Characteristics of deceleration capacity and deceleration runs in vasovagal syncope

Li, Jiakun; Sun, Wei; Yang, Xu; Tu, Bin; Cai, Simin; Hu, Feng; Weng, Zhiyuan; Liu, Shangyu; Lai, Zihao; Zheng, Lihui; Yao, Yan

doi:10.1007/s10286-023-00989-z

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Beyond HRV, which is a commonly used objective measure of autonomic nerve tension, DC of heart rate also offers a non-invasive and straightforward assessment. DC is derived from the periodic changes in RR intervals of sinus rhythm, where an increased DC value indicates enhanced vagal excitability and vice versa 29 , 30 . Zheng L 31 found that in patients without recurrence, DC values decreased rapidly one day post-ablation and remained below baseline levels throughout the first postoperative year, suggesting that CNA may prevent recurrence by reducing vagal nerve tension.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of cardioneuroablation for vagal bradycardia in a single arm prospective study

Han,

Shao,

Yang

et al. 2024

Sci Rep

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Cardioneuroablation (CNA) is currently considered as a promising treatment option for patients with symptomatic bradycardia caused by vagotonia. This study aims to further investigate its safety and efficacy in patients suffering from vagal bradycardia. A total of 60 patients with vagal bradycardia who underwent CNA in the First Affiliated Hospital of Xinjiang Medical University from November 2019 to June 2022. Preoperative atropine tests revealed abnormal vagal tone elevation in all patients. First, the electroanatomic structures of the left atrium was mapped out by using the Carto 3 system, according to the protocol of purely anatomy-guided and local fractionated intracardiac electrogram-guided CNA methods. The upper limit of ablation power of superior left ganglion (SLGP) and right anterior ganglion (RAGP) was not more than 45W with an ablation index of 450.Postoperative transesophageal cardiac electrophysiological examination was performed 1 to 3 months after surgery. The atropine test was conducted when appropriate. Twelve-lead electrocardiogram, Holter electrocardiogram, and skin sympathetic nerve activity were reviewed at 1, 3, 6 and 12 months after operation. Adverse events such as pacemaker implantation and other complications were also recorded to analyze the safety and efficacy of CNA in the treatment of vagus bradycardia. Sixty patients were enrolled in the study (38 males, mean age 36.67 ± 9.44, ranging from 18 to 50 years old). None of the patients had a vascular injury, thromboembolism, pericardial effusion, or other surgical complications. The mean heart rate, minimum heart rate, low frequency, low/high frequency, acceleration capacity of rate, and skin sympathetic nerve activity increased significantly after CNA. Conversely, SDNN, PNN50, rMSSD, high frequency, and deceleration capacity of rate values decreased after CNA (all P < 0.05). At 3 months after ablation, the average heart rate, maximum heart rate, and acceleration capacity of heart rate remained higher than those before ablation, and the deceleration capacity of heart rate remained lower than those before ablation and the above results continued to follow up for 12 months after ablation (all P < 0.05). There was no significant difference in other indicators compared with those before ablation (all P > 0.05). The remaining 81.67% (49/60) of the patients had good clinical results, with no episodes of arrhythmia during follow-up. CNA may be a safe and effective treatment for vagal-induced bradycardia, subject to confirmation by larger multicenter trials.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of cardioneuroablation for vagal bradycardia in a single arm prospective study

Han,

Shao,

Yang

et al. 2024

Sci Rep

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“…Recently, bradycardia events, referred to as heart rate decelerations, have emerged as potential risk markers for sudden death in post-infarction cardiovascular monitoring [ 23 ]. Intriguingly, these decelerations are observed to increase in patients experiencing vasovagal syncope, a catastrophic event within the realm of cardiovascular self-organized criticality [ 24 ]. Gañán-Calvo and Fajardo-López refined the concept of cardiovascular sequences to propose a graphical analysis of heart rate variability, revealing two universal arrhythmic patterns as specific health signatures: one reflecting cardiac adaptability and the other indicating cardiac–respiratory rate tuning [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Purported Self-Organized Criticality of the Cardiovascular Function: Methodological Considerations for Zipf’s Law Analysis

Fortrat

2024

Entropy

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Self-organized criticality is a universal theory for dynamical systems that has recently been applied to the cardiovascular system. Precise methodological approaches are essential for understanding the dynamics of cardiovascular self-organized criticality. This study examines how the duration and quality of data recording affect the analysis of cardiovascular self-organized criticality, with a focus on the beat-by-beat heart rate variability time series obtained from seven healthy subjects in a standing position. Drawing a Zipf diagram, we evaluated the distribution of cardiovascular events of bradycardia and tachycardia. We identified tipping points for the distribution of both bradycardia and tachycardia events. By varying the recording durations (1, 2, 5, 10, 20, 30, and 40 min) and sampling frequencies (500, 250, and 100 Hz), we investigated their influence on the observed distributions. While shorter recordings can effectively capture cardiovascular events, they may underestimate the variables describing their distribution. Additionally, the tipping point of the Zipf distribution differs between bradycardia and tachycardia events. Comparisons of the distribution of bradycardia and tachycardia events should be conducted using long data recordings. Utilizing devices with lower sampling frequencies may compromise data fidelity. These insights contribute to refining experimental protocols and advancing our understanding of the complex dynamics underlying cardiovascular regulation.

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How low can you go: heart rate dynamics in between vasovagal syncope

Thijs,

Raj

2023

Clin Auton Res

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Characteristics of deceleration capacity and deceleration runs in vasovagal syncope

Cited by 3 publications

References 25 publications

Safety and efficacy of cardioneuroablation for vagal bradycardia in a single arm prospective study

Safety and efficacy of cardioneuroablation for vagal bradycardia in a single arm prospective study

Purported Self-Organized Criticality of the Cardiovascular Function: Methodological Considerations for Zipf’s Law Analysis

How low can you go: heart rate dynamics in between vasovagal syncope

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