Circadian variation of human ventricular fibrillation dominant frequency

Abstract

Aim Circadian variation in human ventricular fibrillation (VF) dominant frequency is unknown. If present this would provide evidence of physiological influence on VF. The objective was to quantify the circadian variation in human VF dominant frequency. Methods Eight-lead Holter ECG recordings were obtained from a patient with severe myocarditis and chronic VF who was supported by a biventricular assist device. Recordings of up to 24 h duration were obtained on 6 days with an average interval between recordings of 7 days. Dominant frequency and amplitude were obtained using spectral analysis and assessed for (i) circadian (ii) inter-recording and (iii) inter-lead differences. Results There was a significant circadian variation in amplitude (night: 0.027 ± 0.004 mV Hz vs day: 0.044 ± 0.006 mV Hz, p < 0.0001) but not dominant frequency (night: 7.85 ± 0.62 Hz vs day: 7.93 ± 0.54 Hz, p > 0.05). There were significant differences between recordings in dominant frequency which ranged from 6.80 ± 0.29 Hz to 8.36 ± 0.38 Hz ( p < 0.0001) and dominant frequency spectral amplitude which ranged from 0.033 ± 0.014 mV Hz to 0.043 ± 0.017 mV Hz ( p < 0.0001). Histograms of dominant frequencies in leads exhibited strikingly different distributions, particularly in V2 that was characterised by a bimodal distribution, while the other leads were characterised by predominantly unimodal distributions. Conclusion VF dominant frequency spectral amplitude exhibited circadian variability. In a patient with severe myocarditis, supported with a biventricular assist device and in chronic VF, these results provide evidence for modulation of VF, probably induced by changes in posture and physical activity.