A.N. SolovyanStructural and functional condition of myocardium, heart rate variability and electrophysiological heart properties in patients with paroxysmal atrial fibrillation of different genesis

The аim – to explore the structural and functional characteristics, heart rate variability (HRV), electrophysiological heart properties and their interrelation in pts with paroxysmal atrial fibrillation (PAF) depending on the disease etiology.
Material and methods. 343 pts with non-valvular PAF were included in the study and divided in 4 groups based on etiology. 2D- and Doppler echocardiography and Holter monitoring with HRV analysis were used. Conducting heart system function and atrium vulnerability (AV) were evaluated by transesophageal electrophysiology. AV was studied by inducibility of AF, detection of AF frequency threshold (FT) and AF frequency point (FP) at AF paroxysm induction.
Results. Minimal but significant differences of size of left atrium (LA), interventricular septum thickness (IST) and posterior wall of LV were found in pts with myocardiofibrosis. Functional parameters of LV (ESV, EDV, EDS, ESS) were elevated (P<0.05) but EV – decreased in IHD pts compared with pts with concomitant arterial hypertension (AH). A wave speed attenuation and diminution of E/A ratio (P<0.05) were detected in pts with IHD independent of AH. HRV parameters were reduced in pts with IHD and IHD plus AH (P<0.05). AV enhancement in IHD pts was demonstrated by attenuation of sinus node function (P<0.05) and FP decrease (P=0.08). Conclusion. In PAF pts significant interrelation between heart structural and electrophysiological parameters was revealed: direct – between LA index and ff min and ff max intervals, ff mid and E/A; reverse – between FT and EDV, ESV of LV, FP and EDV of LV, wave f amplitude and EDV, A of LV.

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