Atrial fibrillation is associated with decreased cardiac sympathetic response to isometric exercise in CHF in comparison to sinus rhythm

Gould, Paul A., Esler, Murray D. and Kaye, David M. (2008) Atrial fibrillation is associated with decreased cardiac sympathetic response to isometric exercise in CHF in comparison to sinus rhythm. Pace-Pacing and Clinical Electrophysiology, 31 9: 1125-1129. doi:10.1111/j.1540-8159.2008.01152.x


Author Gould, Paul A.
Esler, Murray D.
Kaye, David M.
Title Atrial fibrillation is associated with decreased cardiac sympathetic response to isometric exercise in CHF in comparison to sinus rhythm
Journal name Pace-Pacing and Clinical Electrophysiology   Check publisher's open access policy
ISSN 0147-8389
1540-8159
Publication date 2008-09-01
Year available 2008
Sub-type Article (original research)
DOI 10.1111/j.1540-8159.2008.01152.x
Open Access Status Not Open Access
Volume 31
Issue 9
Start page 1125
End page 1129
Total pages 5
Place of publication Hoboken United States
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Background: The presence of atrial fibrillation (AF) in congestive heart failure (CHF) is accompanied by increased mortality, although the exact mechanism is unclear. In previous studies, we have demonstrated cardiac baroreceptor abnormalities in association with AF and CHF. In this study, we sought to examine the effect of cardiac rhythm on the cardiac sympathetic response to exercise in CHF.

Methods: In 13 CHF patients (six AF, seven SR, left ventricular ejection fraction 31 ± 2%, age 61 ± 1 years), we measured the hemodynamic and cardiac sympathetic response isometric handgrip (IHG) exercise.

Results:
At baseline the groups were well matched. Baseline hemodynamics and cardiac sympathetic activity did not significantly differ between the cohorts. In response to IHG exercise, both groups demonstrated significant hemodynamic responses. In conjunction, the sinus rhythm (SR) group demonstrated a significant increase in cardiac sympathetic response to exercise (P = 0.04) while in contrast the AF group did not (P = 0.6).

Conclusion: In this study, we demonstrate for the first time that the combination of AF and CHF is accompanied by a marked attenuation of the cardiac sympathetic response to acute hemodynamic stress. This implies AF is associated with a further impairment of baroreceptor response in CHF compared to SR. These findings present possible insights to the associated increased mortality and pathogenesis of AF with CHF.
Keyword Atrial fibrillation
Heart failure
Norepinephrine
Exercise
Congestive-heart-failure
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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