Heart rate variability measures poorly predict atrial fibrillation after off-pump coronary artery bypass grafting

Chamchad, Dmitri; Horrow, Jay; Samuels, Louis E.; Nakhamchik, Lev

doi:10.1016/j.jclinane.2010.12.016

Cited by 14 publications

(17 citation statements)

References 23 publications

(29 reference statements)

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“…21,23,24 However, current knowledge about the association between the peculiarities of surgical procedure and post-surgery events caused by the autonomic dysfunction is contradictory. 25-27 Note that in a part of on-pump cardiac surgery patients included in our study, we revealed the increase of HRV (see upper quartile of distributions of ΔSDNN, and ΔTP in Table 2) which differs from the results of other authors. We found no association between autonomic control indices and clinical characteristics of patients including the features of surgical procedure (see Tables 2 and 3).…”

Section: Discussioncontrasting

confidence: 98%

Comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting or correction of valvular heart disease

Shvartz¹,

Kiselev²,

Karavaev³

et al. 2018

J Cardiovasc Thorac Res

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Introduction: Our aim was to perform a comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting (CABG) or surgical correction of valvular heart disease (SCVHD ). Methods: The synchronous 15 minutes records of heart rate variability (HRV) and finger’s photoplethysmographic waveform variability (PPGV) were performed in 42 cardiac surgery patients (12 women) aged 61.8 ± 8.6 years (mean ± standard deviation), who underwent CABG, and 36 patients (16 women) aged 54.2 ± 14.9 years, who underwent SCVHD , before surgery and in 5-7 days after surgery. Conventional time and frequency domain measures of HRV and index S of synchronization between the slow oscillations in PPGV and HRV were analyzed. We also calculated personal dynamics of these indices after surgery. Results: We found no differences (Р > 0.05) in all studied autonomic indices (preoperative and post-surgery) between studied patients’ groups, except for the preoperative heart rate, which was higher in patients who underwent SCVHD (P = 0.013). We have shown a pronounced preoperative and post-surgery variability (magnitude of inter-quartile ranges) of all autonomic indices in studied patients. In the cluster analysis based on cardiovascular autonomic indices (preoperative and post-surgery), we divided all patients into two clusters (38 and 40 subjects) which did not differ in all clinical characteristics (except for the preoperative hematocrit, P = 0.038), index S, and all post-surgery HRV indices. First cluster (38 patients) had higher preoperative values of the HR, TP, HF, and HF%, and lower preoperative values of the LF% and LF/HF. Conclusion: The variability of cardiovascular autonomic indices in on-pump cardiac surgery patients (two characteristic clusters were identified based on preoperative indices) was not associated with their clinical characteristics and features of surgical procedure (including cardioplegia).

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Section: Discussioncontrasting

confidence: 98%

Comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting or correction of valvular heart disease

Shvartz¹,

Kiselev²,

Karavaev³

et al. 2018

J Cardiovasc Thorac Res

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“…In addition, ApEn did not correlate with any other HRV variable, so that the data provide little evidence for a direct relationship between the magnitude of ApEn and the level of autonomic modulation of heart rate. In a similar way, Chamchad et al showed that ApEn provides little complexity in predicting AF after off-pump coronary artery bypass graft surgery [66] and that the CD was independently associated with AF after coronary artery bypass graft surgery, larger values of HRV complexity being associated with the development of post-surgery AF [67].…”

Section: Hrv Analysis During Srmentioning

confidence: 92%

The Contribution of Nonlinear Methods in the Understanding of Atrial Fibrillation

Alcaraz¹,

Rieta²

2013

Atrial Fibrillation - Mechanisms and Treatment

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Additionally, the f wave analysis from surface ECG recordings is complicated by the simultaneous presence of VA, which is of much higher amplitude. Thereby, the dissociation of atrial and ventricular components is mandatory [12]. Nowadays, several methods to extract the AA signal from surface ECG recordings exist. The most powerful techniques are those that exploit the spatial diversity of the multilead ECG, such as the method that solves the blind source separation problem [3] or the spatiotemporal QRST cancellation strategy [13]. However, the performance of these techniques is seriously reduced when recordings are obtained from Holter systems for paroxysmal AF analysis. The reason is that, generally, Holter systems use no more than two or three leads, which are not enough to exploit the ECG spatial information. For single-lead applications, the most widely used alternative to extract the AA is the averaged beat subtraction (ABS). This method relies on the assumption that the average beat can represent, approximately, each individual beat [12]. Recently, a variety of extensions for this method have been proposed [12,14]. Intraatrial EGMNowadays, a variety of intraatrial recording modalities exists, such as bipolar and unipolar recordings from endocardial and epicardial electrodes, optical mapping and noncontact Atrial Fibrillation -Mechanisms and Treatment 182 mapping [15]. Although recordings from each one of these modalities have their own characteristics, unipolar recordings are generally characterized by a substantial far-field contamination, such as VA, whereas bipolar recordings contains local atrial activations of the place in which the electrodes are located. Nonetheless, these recordings are also affected by ventricular interference, especially in recording sites closer to the ventricles, even if its effect is less evident than on unipolar EGMs and surface ECG recordings. Thereby, for the VA cancellation both from unipolar and bipolar recordings, an averaged ventricular interference complex, as in ABS, is usually computed and subtracted from each atrial signal [16,17]. Only remark that the ventricular activations are habitually detected from a surface ECG recording simultaneously acquired for more accuracy.On the other hand, given that atrial dynamics can be analyzed both from simple EGMs and local atrial period (LAP) series, i.e., the sequence of temporal distances between two consecutive local atrial activations, the appropriate identification of these points is a important task in this context. For this purpose, EGMs are habitually high-pass filtering (40-250 Hz) to remove baseline shifts and high-frequency noise [18]. The filtered signal is then rectified, introducing low-frequency components related to the amplitude of the high-frequency oscillations of the original signal. The modulus of the filtered signal is further low-pass filtered (cut-off at 20 Hz) to extract a waveform proportional to the amplitude of the components of occurring at 40-250 Hz. The atrial activations are then detected by thr...

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“…It has been hypothesized that heart rate variability (HRV), which can be used as an indicator of cardiac sympathovagal balance, would alter before the onset of postoperative AF and could be measured using entropy algorithms (Hogue et al, 1998 ). Findings on this have been conflicting, however, with Hogue et al showing a decrease in ApEn upon the onset of AF (Hogue et al, 1998 ), whilst other studies show entropy and HRV analyses provide little predictive value when studying the onset of postoperative AF (Amar et al, 2003 ; Chamchad et al, 2011 ).…”

Section: Current Studies Using Information Theoretic Approaches In Atmentioning

confidence: 99%

Information Theory and Atrial Fibrillation (AF): A Review

et al. 2018

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Atrial Fibrillation (AF) is the most common cardiac rhythm disorder seen in hospitals and in general practice, accounting for up to a third of arrhythmia related hospitalizations. Unfortunately, AF treatment is in practice complicated by the lack of understanding of the fundamental mechanisms underlying the arrhythmia, which makes detection of effective ablation targets particularly difficult. Various approaches to AF mapping have been explored in the hopes of better pinpointing these effective targets, such as Dominant Frequency (DF) analysis, complex fractionated electrograms (CFAE) and unipolar reconstruction (FIRM), but many of these methods have produced conflicting results or require further investigation. Exploration of AF using information theoretic-based approaches may have the potential to provide new insights into the complex system dynamics of AF, whilst also providing the benefit of being less reliant on empirically derived definitions in comparison to alternate mapping approaches. This work provides an overview of information theory and reviews its applications in AF analysis, with particular focus on AF mapping. The works discussed in this review demonstrate how understanding AF from a signal property perspective can provide new insights into the arrhythmic phenomena, which may have valuable clinical implications for AF mapping and ablation in the future.

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Heart rate variability measures poorly predict atrial fibrillation after off-pump coronary artery bypass grafting

Cited by 14 publications

References 23 publications

Comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting or correction of valvular heart disease

Comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting or correction of valvular heart disease

The Contribution of Nonlinear Methods in the Understanding of Atrial Fibrillation

Information Theory and Atrial Fibrillation (AF): A Review

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