Predictors of Paroxysmal Atrial Fibrillation: Heart Rate Variability and Heart Rate Turbulence

Aim: Autonomic dysfunction is one of the major contributors to atrial fibrillation (AF) development and recurrence.Predicting AF using autonomic dysfunction parameters such as heart rate variability (HRV) and heart rate turbulence (HRT) in patients with risk factors may influence our daily practice.Thus we compare HRV and HRT measurements derived from 24 hours Holter ECG between paroxysmal AF (PAF) patients and healthy subjects. Material and Method: A total number of 116 patients were included in this case-control study. All patients underwent a 24-hHolter ECG monitoring.HRV (VLF, LF, HF, SDNN, SDANN, ASDNN, rMSSD, pNN50) and HRT parameters [turbulence onset (TO) and turbulence slope (TS)] were analyzed and compared between groups.According to their HRT parameters, all participants were divided into three groups (HRT-0: normal TO, TS; HRT-1; abnormal TO or TS; HRT-2: abnormal TO and TS).A p-value <0.05 was considered significant.Results: All HRV parameters were impaired in patients with PAF (p<0.05 for all parameters).There was a statistically significant difference between groups in TO (PAF 1.23±2.56;control -1.02±1.35;p= <0.001) and TS (PAF 2.59±2.39;control 3.75±1.49;p=0.002) values.In addition, 62% of the PAF patients were in HRT-2 group, on contrary; healthy subjects were predominantly in HRT-0 group (79%). Conclusion:Abnormal HRV and HRT values may reflect an increased risk of PAF.Patients should be closely monitored when both TS and TO are impaired.AF's potential complications may be prevented by early detection and proper treatment using non-invasive, reproducible, easily accessible 24-h ECG Holter monitoring.