Circadian variation of ventricular tachycardia in acute myocardial infarction

Lucente, Michele; Rebuzzi, Antonio Giuseppe; Lanza, Gaetano Antonio; Tamburi, S.; Cortellessa, Maria Cristina; Coppola, E; Iannarelli, M.; Manzoli, U

doi:10.1016/0002-9149(88)91200-3

Cited by 77 publications

(13 citation statements)

References 23 publications

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“…A study that adjusted the timing of ischemic events for variable time of awakening, demonstrated that time since arising is a much more powerful predictor of event time than actual clock hour [9]. In contrast to Lucente's study about circadian variation of ventricular tachycardia in patients with acute myocardial infarction, where the data were better fitted by the single harmonic model, our data about VF incidence were again better fitted by a 2-harmonic model [12]. We found the same circadian trend when considering VF patients only, comfirming the hypothesis that a degeneration of VF, possibly preceded by a ventricular tachycardia (VT) to asystole is the most common final event leading to sudden cardiac death [11].…”

Section: Discussioncontrasting

confidence: 81%

Further prospective evidence of a circadian variation in the frequency of call for sudden cardiac death

Martens

Calle

Poel³

et al. 1995

Intensive Care Med

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Section: Discussioncontrasting

confidence: 81%

Further prospective evidence of a circadian variation in the frequency of call for sudden cardiac death

Martens

Calle

Poel³

et al. 1995

Intensive Care Med

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“…A similar circadian trend of ventricular arrhythmias with the highest occurrence in the awake hours has been described by other authors [4,17,26,51]. In two studies .the influence of sleep on VPB was investigated polysomnographically [16,41].…”

Section: Ventricular Arrhythmiassupporting

confidence: 60%

Cardiac arrhythmias during sleep

Coccagna

2000

Somnologie

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Sleep SummaryDifferent types of cardiac arrhythmias may arise in healthy subjects during sleep. Whereas bradyarrhythmias (severe sinus bradycardia, sinus arrest, first and second degree A-V blocks) predominate in the young, elderly subjects more commonly present supraventricular and ventricular ectopic beats and tachyarrhythmias (supraventricular paroxysmal tachycardia, atrial flutter, etc.). A rare potentially life-threatening syndrome, characterised by sinus arrests accompanied by vagal overactivity, has been described in young healthy adults during REM sleep. A sudden death during sleep in apparent healthy Southeast Asian immigrants in the U.S., has been described, may be related to ventricular fibrillation. The frequency of episodes of paroxysmal supraventricular tachycardia appears to follow a circadian rhythm, presenting a minimum peak between 4 and 6 a. m. and two maximal peaks in the morning and afternoon. In contrast, the likelihood for development of an episode of paroxysmal atrial fibrillation (PAF) is the same in wakefulness, slow sleep and REM sleep. Power spectral analysis of heart rate variability has established that PAF episodes are always preceded by a shift in the sympathovagal balance towards the sympathetic limb. The influence of sleep on ventricular arrhythmias (ventricular premature beats (VPB) and ventricular tachycardia (VT)) is more controversial. Most studies show that sleep exerts an inhibitory effect on ventricular arrhythmias with a possible circadian trend (the lowest incidence occurring in the early morning hours). Our polygraphic studies failed to disclose any effect of sleep on ventricular arrhythmias. Obstructive sleep apnea syndrome (OSAS) is one of the most common causes of cardiac arrhythmias during sleep. Of these, the most frequent is brady-tachyarrhythmia. First and second degree atrioventral blocks, severe bradycardia and sinus arrests lasting over 2.5 s. (but also more than 10 s.) are also common. Even though these arrhythmias are severe, it has yet to be established whether they are a direct cause of sudden death in OSAS patients.In conclusion, even though many types of arrhythmias may arise in sleep, there is no evidence that sleep is a determinant factor. Some arrhythmias with a minimal incidence in the early hours of the morning appear to be more affected by a circadian rhythm, which are at least partly sleep-dependent. The only arrhythmias truly linked to sleep are sinus arrests in REM sleep and arrhythmias linked to obstructive sleep apneas.Keywords A-V heart blocks -heart rate variability -obstructive sleep apnea -paroxysmal atrial fibrillation -paroxysmal supraventricular tachycardia -sinus bradycardiaventricular ectopic beats -sinus arrest.

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“…Sudden cardiac death is more likely to occur in the morning Willich et al, 1987) and results from myocardial ischaemia (Muller et al, 1989a) or a fatal arrhythmic event Lucente et al, 1988). The morning increase in intrinsic physiological processes such as the elevation of systemic blood pressure, heart rate (Millar-Graig et al, 1978), platelet aggregability (Tof¯er et al, 1987), plasma cortisol (Weitzman et al, 1971) and sympathetic activity (Furlan et al, 1990) may be involved in triggering possibly fatal events.…”

Section: Introductionmentioning

confidence: 99%

Non‐linear cardiac dynamics and morning dip: an unsound circadian rhythm

Yum

Kim

et al. 1999

Clinical Physiology

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The frequency of sudden cardiac death increases in the morning. The relationship between decreased complexity of heart rate dynamics and sudden cardiac death has been documented. An understanding of circadian variation in the complexity of cardiac dynamics may be important to predict and prevent sudden cardiac death. Dynamic 24-h electrocardiographic recordings were obtained from 30 healthy ambulant subjects aged 41-50 years, and the digitized data were partitioned into sections of 30 min duration. For each section, four indexes obtained from separate algorithms of non-linear dynamics of the RR interval--modified correlation dimension, Lyapunov exponent, approximate entropy, and fractal dimension--were calculated. Normalized low-(0.04-0.15 hertz) and high-frequency (> 0.15 hertz) components were also calculated. All four indexes of non-linear dynamics showed a remarkably similar circadian rhythm: a prominent morning dip preceded by a steep decline during the late night, a recovery during the evening and a peak around midnight. In the morning, the low-frequency component rose rapidly with concomitant reduction in the high-frequency component. The complexity of cardiac dynamics decreases significantly in the morning, and this may contribute to the ominously increased rate of cardiac death in the morning hours.

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Circadian variation of ventricular tachycardia in acute myocardial infarction

Cited by 77 publications

References 23 publications

Further prospective evidence of a circadian variation in the frequency of call for sudden cardiac death

Further prospective evidence of a circadian variation in the frequency of call for sudden cardiac death

Cardiac arrhythmias during sleep

Non‐linear cardiac dynamics and morning dip: an unsound circadian rhythm

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