B-PO02-153 FLUCTUATIONS OF HEART RATE COMPLEXITY 5-MINUTE BEFORE AND AFTER PAROXYSMAL ATRIAL FIBRILLATION EVENTS: INSIGHT FROM NONLINEAR HEART RATE VARIABILITY

Abstract

Autonomic modulation has been reported to related to the onset and termination of paroxysmal AF (PAF) from the linear heart rate variability (HRV). It has never been reported using the nonlinear HRV before & after the PAF events. We aimed to evaluate the changes of heart rate complexity through the nonlinear HRV analysis before & after the PAF events. We enrolled 65 patients (72 ± 12.34 years old, 31 females) with 99 PAF events who received 24-hour Holter recording. The nonlinear HRV variables, including the sample entropy (SampEn), the multi-scale entropy (MSE), and the Poincaré Plot analysis, were analyzed. HRV analyses were applied to a 20-minute window before & after the PAF events. HRV variables were evaluated based on the 5-minute time segments as we divided the 20-minute window into 8 segments. HRV variables SampEn and MSE1∼5 significantly decreased before the onset of PAF events, whereas SampEn, MSE1∼5, MSE6∼20 elevated after the termination of PAF events. SD1 and SD2, which are generated from the Poincaré Plot analysis, did not have significant changes before the PAF events. SD1 and SD2 decreased significantly after the PAF termination. Detailed serial changes of HRV variables before & after the PAF events are shown in the Table 1. In our study, the heart rate complexity, as assessed by SampEn and MSE1∼5, significantly decreased before the onset and increased after the termination of PAF. SD1, which is a marker highly related to vagal tone activity, decreased after PAF termination. These findings indicate the fluctuations of heart rate complexity and the withdrawal of vagal activities are important in the initiation and termination of PAF.