Spectral analysis of heart rhythm variability in atrial fibrillation patients using sotalol and bisoprolol

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  • Authors: Popova E.P.1, Bogova O.T.2, Chandirli S.A.2, Shueb A.A.2, Puzin S.N.2, Sychev D.A.2, Fisenko V.P.1
  • Affiliations:
    1. I.M. Sechenov First Moscow State Medical University (Sechenov University)
    2. Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation
  • Issue: Vol 75, No 2 (2020)
  • Pages: 135-143
  • Section: CARDIOLOGY AND CARDIOVASCULAR SURGERY: CURRENT ISSUES
  • URL: https://vestnikramn.spr-journal.ru/jour/article/view/1102
  • DOI: https://doi.org/10.15690/vramn1102
  • Cite item
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Abstract


Background. Atrial Fibrillation is one of the most common arrhythmias. Despite the different attitude to the pharmacotherapy of Atrial Fibrillation, the problem of selection of adequate antiarrhythmic therapy for the prevention and treatment of persistent Atrial Fibrillation remains relevant and is of great interest to researchers. For the effective selection of drugs in the treatment of arrhythmia can be successfully used the method of spectral analysis of heart rhythm variability.

Aims: to study the effect of antiarrhythmic drug Sotalol and β-adrenoblocker Bisoprolol on the spectral parameters of heart rhythm variability in patients with Atrial Fibrillation.

Methods. 167 patients with Atrial Fibrillation of both sexes aged 46 to 94 years were examined. The study included patients with the first diagnosed Atrial Fibrillation, and with persistent Atrial Fibrillation during of 6 months to 8 years. Arterial hypertension has diagnosed in all patients. Also, patients were diagnosed with coronary heart disease with a history of myocardial infarction and without myocardial infarction. Spectral analysis of heart rhythm variability was conducted in patients with Atrial Fibrillation. Therapy in patients was performed with the antiarrhythmic drug Sotalol (80−160 mg, orally) and Bisoprolol (2.5−5 mg, orally).

Results. Spectral analysis of heart rhythm variability in patients Atrial Fibrillation using Sotalol showed that the proportion of VLF in patients with the first diagnosed Atrial Fibrillation is more than half of the spectrum, whereas in patients with persistent Atrial Fibrillation this parameter is 18%, the proportion of LF is higher in patients with persistent Atrial Fibrillation. The coefficient LF/HF in patients with persistent Arial Fibrillation is two times lower than in patients with the first diagnosed Atrial Fibrillation. Spectral analysis of heart rhythm variability in patients Atrial Fibrillation using Bisoprolol, it was shown that the proportion of LF in patients with the first diagnosed Atrial Fibrillation was 2 times lower, and the proportion of HF was twice higher than in patients with persistent Atrial Fibrillation.

Conclusions. In this study, a spectral analysis of heart rate variability in patients with Atrial Fibrillation, who receive antiarrhythmic drug therapy with sotalol and bisoprolol, was carried out. It was found that humoral factors play a significant role in patients with the first diagnosed Atrial Fibrillation during sotalol therapy, the role of the vagus in this group of patients is minimal, while in patients with bisoprolol therapy the vagus has a dominant effect on the activity of the heart.


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About the authors

Ekaterina P. Popova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: kispo-pharm@mail.ru
ORCID iD: 0000-0002-1717-730X
SPIN-code: 5789-0451

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

candidate of biological Sciences, Associate Professor

Olga T. Bogova

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: bogova.olga@yandex.ru
ORCID iD: 0000-0001-5406-7225
SPIN-code: 6116-0120

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

MD, PhD, Professor

Sevda A. Chandirli

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: cha-seva2@yandex.ru
ORCID iD: 0000-0002-1869-0869
SPIN-code: 8633-9570

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

MD, PhD

Ayshat A. Shueb

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: maritta40@mail.ru
ORCID iD: 0000-0003-4451-5893
SPIN-code: 2775-0367

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

аспирант кафедры гериатрии и медико-социальной экспертизы

Sergey N. Puzin

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: s.puzin2012@yandex.ru
ORCID iD: 0000-0003-1030-8319
SPIN-code: 2206-0700

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

заведующий кафедрой гериатрии и медико-социальной экспертизы

Dmitry A. Sychev

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: dimasychev@mail.ru
ORCID iD: 0000-0002-4496-3680
SPIN-code: 4525-7556

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

MD, PhD, Professor

Vladimir P. Fisenko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: vpfisenko@mail.ru
ORCID iD: 0000-0002-9080-5763
SPIN-code: 5187-6425

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

MD, PhD, Professor

References

  1. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study. Circulation. 2014;129(8):837–847. doi: 10.1161/CIRCULATIONAHA.113.005119.
  2. Heijman J, Voigt N, Nattel S, Dobrev D. Cellular and molecular electrophysiology of atrial fibrillation initiation, maintenance, and progression. Circ Res. 2014;114(9):1483–1499. doi: 10.1161/CIRCRESAHA.114.302226.
  3. Sardar MR, Saeed W, Kowey PR. Antiarrhythmic drug therapy for atrial fibrillation. Heart Fail Clin. 2016;12(2):205–221. doi: 10.1016/j.hfc.2015.08.017.
  4. Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC). Europace. 2011;12(10):1360–1420. doi: 10.1093/europace/euq350.
  5. Lafuente-Lafuente C, Valembois L, Bergmann JF, Belmin J. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2015;(3):CD005049. doi: 10.1002/14651858.CD005049.pub4.
  6. Halsey C, Chugh A. Rate versus rhythm control for atrial fibrillation. Cardiol Clin. 2014;32(4):521–531. doi: 10.1016/j.ccl.2014.07.011.
  7. Kirchhof P, Breithardt G, Bax J, et al. A roadmap to improve the quality of atrial fibrillation management: proceedings from the fifth Atrial Fibrillation Network. European Heart Rhythm Association consensus conference. Europace. 2016;18(1):37−50. doi: 10.1093/europace/euv304.
  8. Patel PA, Ali N, Hogarth A, Tayebjee MH. Management strategies for atrial fibrillation. J R Soc Med. 2017;110(1):13−22. doi: 10.1177/0141076816677857.
  9. Matsuo S, Lim KT, Haissaguerre M. Ablation of chronic atrial fibrillation. Heart Rhythm. 2007;4(11):1461–1463. doi: 10.1016/j.hrthm.2007.07.016.
  10. Camm AJ, Camm CF, Savelieva I. Medical treatment of atrial fibrillation. J Cardiovasc Med (Hagerstown). 2012;13(2):97–107. doi: 10.2459/JCM.0b013e32834f23e1.
  11. Hanley CM, Robinson VM, Kowey PR. Status of antiarrhythmic drug development for atrial fibrillation: new drugs and new molecular mechanisms. Circ Arrhythm Electrophysiol. 2016;9(3):1−9. doi: 10.1161/CIRCEP.115.002479.
  12. Kanagaratnam L, Kowey P, Whalley D. Pharmacological therapy for rate and rhythm control for atrial fibrillation in 2017. Heart Lung Circ. 2017;26(9):926−933. doi: 10.1016/j.hlc.2017.05.134.
  13. Баевский Р.М., Иванов И.И., Чирейкин Л.В., и др. Анализ вариабельности сердечного ритма при использовании различных электрокардиографических систем (методические рекомендации) // Вестник аритмологии. ― 2002. ― №24. ― С. 65−87. [Baevsky RM, Ivanov II, Chireikin LV, et al. Analys variabelnosty serdechnogo rytma pry ispolzovanii razlichnyh elektrokardiograficheskih system (metodicheskie rekomendacii). Vestnik aritmologii. 2002;(24):65−87. (In Russ).]
  14. Task forse of the European Society of Cardiology and the North American Society of Paciety of Pacing and Electrophysiology. Heart rate variability. Standarts of measurements, physiological interpretation and clinical use. Circulation. 1996;93(5):1043−1065. doi: 10.1161/01.cir.93.5.1043.
  15. Hohendanner F, Heinzel FR, Blaschke F, et al. Pathophysiological and therapeutic implications in patients with atrial fibrillation and heart failure. Heart Fail Rev. 2018;23(1):27−36. doi: 10.1007/s10741-017-9657-9.
  16. Martins RP, Kaur K, Hwang E, et al. Dominant frequency increase rate predicts transition from paroxysmal to long-term persistent atrial fibrillation. Circulation. 2014;129(14):1472−1482. doi: 10.1161/CIRCULATIONAHA.113.004742.
  17. DiPiro JT, Talbert RL, Yee GC, et al. Members of the Sicilian gambit: antiarrhythmic therapy: a pathophysiologic approach. Armonk, N.Y., Futura Publishing Co., Inc.; 1994.
  18. Bellandi F, Cantini F, Pedone T, et al. [The efficacy of intravenous propafenone and amiodarone in the conversion of recent onset atrial fibrillation. All year follow up with oral treatment. (In Italian)]. G Ital Cardiol. 1993;23(3):261−271.
  19. Kalusche D, Stockinger J, Betz P, Roskamm H. [Sotalol and quinidine/verapamil (Cordichin) in chronic atrial fibrillation ― conversion and 12-month follow-up--a randomized comparison. (In German)]. Z Kardiol. 1994;83 Suppl 5:109−116..
  20. Reimold SC, Cantillon CC, Friedman PL, et al. Propafenon versus sotalol for suppression of recurrent symptomatic atrial fibrillation. Am J Cardiol. 1993;71(7):558−563. doi: 10.1016/0002-9149(93)90511-a.
  21. Coplen SE, Anman EM, Berlin JA, et al. Efficacy and safety of quinidine therapy for maintenance of sinus rhythm after cardioversion: a meta-analysis of randomezed control trials. Circulation. 1990;82(4):1106−1116. doi: 10.1161/01.cir.82.4.1106.
  22. Anderson JL, Gilbert EM, Alpert BL, et al. Prevention of symptomatic recurrences of paroxysmal atrial fibrillation in patients initially tolerating antiarhythmic therapy. A multi-center, double-blind, crossover study of flecainide and placebo with transtelephonic monitoring, Flecainide Supraventricuar Tachycardia Study Group. Circulation. 1989;80(6):1557−1570. doi: 10.1161/01.cir.80.6.1557.
  23. Flaker GC, Blackshear JL, McBride R, el al. Antiarrhythmic drug therapy and cardiac mortality in atrial fibrillation. J Am Coil Cardiol. 1992;20(3):527−532. doi: 10.1016/0735-1097(92)90003-6.
  24. Juun-Moller S, Edvardson N, Rehnqvist-Ahlberg N. Sotalol direct quinidine for the maintenance of sinus rhythm after direct current convertion of atrial fibrillation. Circullation. 1990;82(6):1932−1939. doi: 10.1161/01.cir.82.6.1932.
  25. Искендеров Б.Г., Рахматуллов Ф.К. Структурные и электрофизиологические показатели функции сердца при пароксизмальной мерцательной аритмии // Терапевтический архив. ― 2001. ― Т.73. ― №12. ― С. 52−56. [Iskenderov BG, Rakhmatullov FK. Strukturnyye i elektrofiziologicheskiye pokazateli funktsii serdtsa pri paroksizmal’noy mertsatel’noy aritmii. Ter arkh. 2001;73(12):52−56. (In Russ).]

Supplementary files

Supplementary Files Action
1.
Fig. 1. The effect of sotalol and bisoprolol on the structure of the spectrum of heart rate variability in patients with various forms of atrial fibrillation

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2.
Fig. 2. The effect of sotalol and bisoprolol on the LF / HF ratio in patients with various forms of atrial fibrillation

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