Abstract
Heart rate variability (HRV) analysis is a useful method for assessment of the activities of autonomic nervous system. The RR intervals in ECG is measured for this purpose. However, RR intervals are not suitable for HRV analysis in atrioventricular block (AV) block patients with ventricular inhibited (VVI) pacemaker, as the intervals will be fixed by the ventricular pacemaker. Thus we used an esophageal lead to detect PP intervals for analysis of HRV. The aim of this study was to evaluate the short-term HRV by using an esophageal electrode to detect the atrial signal and PP intervals in AV block patients. Fifteen AV block patients before and after temporary VVI pacemaker and 15 subjects with normal AV conduction (control group) were enrolled in this study. The atrial signals from esophageal lead, ECG and intraatrial lead were recorded. The duration was 10 min. We compared correlation coefficient of PP intervals from different leads in AV block patients and the control group. We also compared the PP interval's variability parameters between the control group and AV block patients, before and after insertion of a temporary ventricular inhibited pacemaker. The esophageal PP intervals were excellently correlated with intraatrial AA intervals (r=0.98±0.01). The HRV using esophageal PP intervals with time domain demonstrated a significant decrease in patients with AV block (standard deviation of all PP intervals (SDNN) (s)=0.022±0.014; percentage difference between adjacent PP intervals that are greater than 50 ms (pNN- 50) (%)=0.052±0.038; square root of the mean of squares of differences between duration of neighboring PP intervals (r-MSDD) (s)=0.322±0.082) but this returned to normal after insertion of a temporary ventricular inhibited pacemaker (SDNN (s)=0.035±0.009; pNN-50 (%)=2.540±1.682; r-MSDD (s)=0.542±0.190). However, the ratio of low frequency/high frequency (LF/HF) still increased (LF/HF=4.120±1.802). The result of this short-term HRV analysis suggested that withdrawal of vagal tone or increased sympathetic activity in AV block patients compared with the control group. This appearance was normalized after insertion of a temporary VVI pacemaker. However, abnormal sympathovagal balance still remained.
| Original language | English |
|---|---|
| Pages (from-to) | 271-276 |
| Number of pages | 6 |
| Journal | International Journal of Cardiology |
| Volume | 64 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - May 15 1998 |
| Externally published | Yes |
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Keywords
- AV block
- Esophageal lead
- Heart rate variability
- PP intervals
- VVI pacemaker
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Esophageal PP intervals for analysis of short-term heart rate variability in patients with atrioventricular block before and after insertion of a temporary ventricular inhibited pacemaker. / Hsiao, Hsiang Chiang; Chiu, Hung Wen; Lee, Shiao Chuan; Kao, Tsiar; Chang, Hsin Ya; Kong, Chi Woon.
In: International Journal of Cardiology, Vol. 64, No. 3, 15.05.1998, p. 271-276.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Esophageal PP intervals for analysis of short-term heart rate variability in patients with atrioventricular block before and after insertion of a temporary ventricular inhibited pacemaker
AU - Hsiao, Hsiang Chiang
AU - Chiu, Hung Wen
AU - Lee, Shiao Chuan
AU - Kao, Tsiar
AU - Chang, Hsin Ya
AU - Kong, Chi Woon
PY - 1998/5/15
Y1 - 1998/5/15
N2 - Heart rate variability (HRV) analysis is a useful method for assessment of the activities of autonomic nervous system. The RR intervals in ECG is measured for this purpose. However, RR intervals are not suitable for HRV analysis in atrioventricular block (AV) block patients with ventricular inhibited (VVI) pacemaker, as the intervals will be fixed by the ventricular pacemaker. Thus we used an esophageal lead to detect PP intervals for analysis of HRV. The aim of this study was to evaluate the short-term HRV by using an esophageal electrode to detect the atrial signal and PP intervals in AV block patients. Fifteen AV block patients before and after temporary VVI pacemaker and 15 subjects with normal AV conduction (control group) were enrolled in this study. The atrial signals from esophageal lead, ECG and intraatrial lead were recorded. The duration was 10 min. We compared correlation coefficient of PP intervals from different leads in AV block patients and the control group. We also compared the PP interval's variability parameters between the control group and AV block patients, before and after insertion of a temporary ventricular inhibited pacemaker. The esophageal PP intervals were excellently correlated with intraatrial AA intervals (r=0.98±0.01). The HRV using esophageal PP intervals with time domain demonstrated a significant decrease in patients with AV block (standard deviation of all PP intervals (SDNN) (s)=0.022±0.014; percentage difference between adjacent PP intervals that are greater than 50 ms (pNN- 50) (%)=0.052±0.038; square root of the mean of squares of differences between duration of neighboring PP intervals (r-MSDD) (s)=0.322±0.082) but this returned to normal after insertion of a temporary ventricular inhibited pacemaker (SDNN (s)=0.035±0.009; pNN-50 (%)=2.540±1.682; r-MSDD (s)=0.542±0.190). However, the ratio of low frequency/high frequency (LF/HF) still increased (LF/HF=4.120±1.802). The result of this short-term HRV analysis suggested that withdrawal of vagal tone or increased sympathetic activity in AV block patients compared with the control group. This appearance was normalized after insertion of a temporary VVI pacemaker. However, abnormal sympathovagal balance still remained.
AB - Heart rate variability (HRV) analysis is a useful method for assessment of the activities of autonomic nervous system. The RR intervals in ECG is measured for this purpose. However, RR intervals are not suitable for HRV analysis in atrioventricular block (AV) block patients with ventricular inhibited (VVI) pacemaker, as the intervals will be fixed by the ventricular pacemaker. Thus we used an esophageal lead to detect PP intervals for analysis of HRV. The aim of this study was to evaluate the short-term HRV by using an esophageal electrode to detect the atrial signal and PP intervals in AV block patients. Fifteen AV block patients before and after temporary VVI pacemaker and 15 subjects with normal AV conduction (control group) were enrolled in this study. The atrial signals from esophageal lead, ECG and intraatrial lead were recorded. The duration was 10 min. We compared correlation coefficient of PP intervals from different leads in AV block patients and the control group. We also compared the PP interval's variability parameters between the control group and AV block patients, before and after insertion of a temporary ventricular inhibited pacemaker. The esophageal PP intervals were excellently correlated with intraatrial AA intervals (r=0.98±0.01). The HRV using esophageal PP intervals with time domain demonstrated a significant decrease in patients with AV block (standard deviation of all PP intervals (SDNN) (s)=0.022±0.014; percentage difference between adjacent PP intervals that are greater than 50 ms (pNN- 50) (%)=0.052±0.038; square root of the mean of squares of differences between duration of neighboring PP intervals (r-MSDD) (s)=0.322±0.082) but this returned to normal after insertion of a temporary ventricular inhibited pacemaker (SDNN (s)=0.035±0.009; pNN-50 (%)=2.540±1.682; r-MSDD (s)=0.542±0.190). However, the ratio of low frequency/high frequency (LF/HF) still increased (LF/HF=4.120±1.802). The result of this short-term HRV analysis suggested that withdrawal of vagal tone or increased sympathetic activity in AV block patients compared with the control group. This appearance was normalized after insertion of a temporary VVI pacemaker. However, abnormal sympathovagal balance still remained.
KW - AV block
KW - Esophageal lead
KW - Heart rate variability
KW - PP intervals
KW - VVI pacemaker
UR - http://www.scopus.com/inward/record.url?scp=0032524757&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032524757&partnerID=8YFLogxK
U2 - 10.1016/S0167-5273(98)00078-3
DO - 10.1016/S0167-5273(98)00078-3
M3 - Article
VL - 64
SP - 271
EP - 276
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -