Circadian distribution of paroxysmal atrial fibrillation in patients with and without structural heart disease in untreated state

Yoshiaki Deguchi, Mari Amino, Kumiko Adachi, Atsushi Matsuzaki, Osamu Iwata, Koichiro Yoshioka, Eiichi Watanabe, Teruhisa Tanabe

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Abstract

Background: This study aimed to compare the circadian distribution of the onset, maintenance and termination of paroxysmal atrial fibrillation (PAF) between structural and non-structural heart diseases (SHD and NSHD, respectively) in the untreated state. Subjects and Methods: We included 217 patients with 338 PAF (79 SHD patients with 131 episodes; 138 NSHD patients with 207 episodes). The probabilities for the onset, maintenance and termination of PAF for each hour were analyzed using Holter monitoring data and harmonic models being fitted into a cosinusoidal function. Results: The SHD group had a triphasic circadian pattern at the onset with higher peaks at midnight, in the early morning and in the late afternoon (p < 0.05), whereas the NSHD group showed a single peak at midnight (p < 0.01). The probability of maintenance revealed a single peak during midnight (SHD, p < 0.0001; NHD, p < 0.01). The termination showed a peak at noon in the SHD group (p < 0.05), whereas there was a double peak at 10:00 am and 8:00 pm in the NSHD group (p = 0.06). RR intervals just after the PAF onset showed marked shortening in the daytime initiation PAF as compared to the nighttime initiation PAF in both SHD and NSHD groups (p < 0.01). Conclusion: These observations suggest that the SHD group has very complex onset hours, whereas the NSHD group shows complex termination hours. Reflexly accelerated sympathetic tone just after the PAF onset is suggested in the daytime initiation PAF.

Original languageEnglish
Pages (from-to)280-289
Number of pages10
JournalAnnals of Noninvasive Electrocardiology
Volume14
Issue number3
DOIs
Publication statusPublished - 01-07-2009

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Atrial Fibrillation
Heart Diseases
Maintenance
Ambulatory Electrocardiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Deguchi, Yoshiaki ; Amino, Mari ; Adachi, Kumiko ; Matsuzaki, Atsushi ; Iwata, Osamu ; Yoshioka, Koichiro ; Watanabe, Eiichi ; Tanabe, Teruhisa. / Circadian distribution of paroxysmal atrial fibrillation in patients with and without structural heart disease in untreated state. In: Annals of Noninvasive Electrocardiology. 2009 ; Vol. 14, No. 3. pp. 280-289.
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Circadian distribution of paroxysmal atrial fibrillation in patients with and without structural heart disease in untreated state. / Deguchi, Yoshiaki; Amino, Mari; Adachi, Kumiko; Matsuzaki, Atsushi; Iwata, Osamu; Yoshioka, Koichiro; Watanabe, Eiichi; Tanabe, Teruhisa.

In: Annals of Noninvasive Electrocardiology, Vol. 14, No. 3, 01.07.2009, p. 280-289.

Research output: Contribution to journalArticle

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AU - Deguchi, Yoshiaki

AU - Amino, Mari

AU - Adachi, Kumiko

AU - Matsuzaki, Atsushi

AU - Iwata, Osamu

AU - Yoshioka, Koichiro

AU - Watanabe, Eiichi

AU - Tanabe, Teruhisa

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N2 - Background: This study aimed to compare the circadian distribution of the onset, maintenance and termination of paroxysmal atrial fibrillation (PAF) between structural and non-structural heart diseases (SHD and NSHD, respectively) in the untreated state. Subjects and Methods: We included 217 patients with 338 PAF (79 SHD patients with 131 episodes; 138 NSHD patients with 207 episodes). The probabilities for the onset, maintenance and termination of PAF for each hour were analyzed using Holter monitoring data and harmonic models being fitted into a cosinusoidal function. Results: The SHD group had a triphasic circadian pattern at the onset with higher peaks at midnight, in the early morning and in the late afternoon (p < 0.05), whereas the NSHD group showed a single peak at midnight (p < 0.01). The probability of maintenance revealed a single peak during midnight (SHD, p < 0.0001; NHD, p < 0.01). The termination showed a peak at noon in the SHD group (p < 0.05), whereas there was a double peak at 10:00 am and 8:00 pm in the NSHD group (p = 0.06). RR intervals just after the PAF onset showed marked shortening in the daytime initiation PAF as compared to the nighttime initiation PAF in both SHD and NSHD groups (p < 0.01). Conclusion: These observations suggest that the SHD group has very complex onset hours, whereas the NSHD group shows complex termination hours. Reflexly accelerated sympathetic tone just after the PAF onset is suggested in the daytime initiation PAF.

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