Heart Rate Rhythm Research Articles

Diurnal rhythms in fetal heart rate baseline and sustained fetal tachycardia in twin pregnancy

Objective To elucidate the synchronization of phases of diurnal rhythms in fetal heart rate (FHR) baseline between twin fetuses and the occurrence of sustained fetal tachycardia. Methods FHR was simultaneously recorded in twins for 24 h in 7 monochorionic diamniotic (MD) and 8 dichorionic diamniotic (DD) twin pregnancies at 35 to 38 weeks of gestation. The diurnal rhythms of the hourly mean FHR baseline were tested in each fetus, and the time of occurrence of sustained fetal tachycardia was compared between twins. The correlation coefficients and phase lags of diurnal rhythms between the hourly mean FHR baselines of twins were calculated in each case. Results There were significant diurnal rhythms in the hourly mean FHR baselines of all twin fetuses ( p < 0.01). The patterns of diurnal rhythms were similar for each pair of twins, with the exception of the periods of sustained fetal tachycardia. Sustained fetal tachycardia was not coincident between twins. Analysis in which the periods of sustained fetal tachycardia were excluded demonstrated a significant correlation between the hourly mean FHR baselines of twins in all cases ( p < 0.01). In the case of DD twins, the phase lag between twins was 0; however, phase lags were observed in 4 cases of MD twins. Conclusions The results of this study revealed that the diurnal rhythms in the FHR baseline correlated well between twins, and that the occurrences of sustained fetal tachycardia were completely independent.

Effects of a Seven‐Day Continuous Infusion of Ropivacaine on Circadian Rhythms in the Rat

The present study was conducted to evaluate the effect of a 7 d continuous infusion of ropivacaine on the 24 h rhythms of body temperature, heart rate, and locomotor activity. After an initial 7 d baseline, rats were randomly divided into two groups of 4 rats each to receive ropivacaine or saline via an osmotic pump for 7 consecutive days. The pumps were removed thereafter and observed during a 7 d recovery span. The studied circadian rhythms were measured by radiotelemetry throughout each of the 7 d periods. An additional group of 4 rats was studied under the same experimental conditions to assess the plasma levels of ropivacaine on days 3 and 8 following pump implantation. Our results indicate that ropivacaine does not induce loss of the circadian rhythms of body temperature, heart rate, or locomotor activity; a prominent period of 24 h was found for all variables in all animals, before, during, and after ropivacaine treatment. However, ropivacaine treatment did modify some characteristics of the rhythms; it increased the MESOR (24 h mean) of the heart rate and locomotor activity rhythms and advanced the acrophase (peak time) of the locomotor activity circadian rhythm. The present study indicates that the circadian rhythms of heart rate and locomotor activity are modified after continuous infusion of ropivacaine, which is of particular interest, given the potential cardiotoxicity of this local anesthetic agent.

Circadian Rhythms in Heart Rate, Motility, and Body Temperature of Wild‐type C57 and eNOS Knock‐out Mice Under Light‐dark, Free‐run, and After Time Zone Transition

The nitric oxide (NO) system is involved in the regulation of the cardiovascular system in controlling central and peripheral vascular tone and cardiac functions. It was the aim of this study to investigate in wild‐type C57BL/6 and endothelial nitric oxide synthase (eNOS) knock‐out mice (eNOS‐/‐) the contribution of NO on the circadian rhythms in heart rate (HR), motility (motor activity [MA]), and body temperature (BT) under various environmental conditions. Experiments were performed in 12∶12 h of a light:dark cycle (LD), under free‐run in total darkness (DD), and after a phase delay shift of the LD cycle by −6 h (i.e., under simulation of a westward time zone transition). All parameters were monitored by radiotelemetry in freely moving mice. In LD, no significant differences in the rhythms of HR and MA were observed between the two strains of mice. BT, however, was significantly lower during the light phase in eNOS‐/‐ mice, resulting in a significantly greater amplitude. The period of the free‐running rhythm in DD was slightly shorter for all variables, though not significant. In general, rhythmicity was greater in eNOS‐/‐ than in C57 mice both in LD and DD. After a delay shift of the LD cycle, HR and BT were resynchronized to the new LD schedule within 5–6 days, and resynchronization of MA occurred within 2–3 days. The results in telemetrically instrumented mice show that complete knock‐out of the endothelial NO system—though expressed in the suprachiasmatic nuclei and in peripheral tissues—did not affect the circadian organization of heart rate and motility. The circadian regulation of the body temperature was slightly affected in eNOS‐/‐ mice.

Long-Term Follow-up of the Circadian Rhythm of Heart Rate and Heart Rate Variability in Healthy Elderly Patients

The long-term age-related changes in circadian rhythm of heart rate variability (HRV), that is, autonomic nervous activity, remain unknown in elderly people. Holter monitoring was conducted twice at an interval of 15 years in 15 healthy elderly patients (age: 70.0 +/- 4.1 years, at first monitoring, female: 10) and assessed the age-related changes in 24-h mean and hourly mean normal sinus R-R interval (mean NN), HRV (high frequency (HF) component, low frequency (LF) component and LF/HF) and the circadian rhythms. As a result, 24-h mean mean NN (0.976 +/- 0.115 vs 0.903 +/- 0.117 (s), p = 0.0019), LF/HF (1.681 +/- 0.731 vs 0.962 +/- 0.442, p = 0.0022), and LF (278.88 +/- 176.43 vs 179.19 +/- 132.33 (ms2), p = 0.0039) significantly decreased 15 years later, although 24-h mean HF (221.20+/-138.89 vs 310.78+/-296.73 (ms2), p = 0.1102) increased slightly. The hourly mean NN closely correlated with hourly HF and LF/HF throughout circadian rhythms both at first and second monitoring. In the morning hours, amplitude rates of all HRV indices increased significantly 15 years later. In elderly people, age-related changes in the 24-h mean heart rate (HR) were conversely dissociated from those of the 24-h mean HRV. However, the close correlation between hourly HR and HRV was preserved, even in very elderly patients. Additionally, the amplitude rates in HRV in the morning increased with age. These age-related changes of HR and HRV might be characteristic of elderly people.

Loss of Diurnal Rhythms of Blood Pressure and Heart Rate Caused by High-Fat Feeding

Diet-induced obesity using ad libitum high-fat feeding in rabbits causes losses in diurnal rhythms of blood pressure (BP) and heart rate (HR). Because obesity is associated with hypertension, it is difficult to determine independent effects of ad libitum feeding and obesity in altering diurnal rhythms. We studied diurnal rhythms of BP and HR after controlling BP during obesity development using hydralazine. New Zealand white rabbits were divided into lean control (LC), lean hydralazine-treated (LH), obese control (OC), and obese hydralazine-treated (OH) groups. Lean animals consumed a maintenance diet, whereas obese animals consumed an ad libitum high-fat diet. Over 12 weeks, BP and HR were monitored from 11:00 to 07:00 using telemetry. Hydralazine treatment consisted of 6 mg/kg/day and 10 to 14 mg/kg/day for LH and OH, respectively. Diurnal rhythms were evaluated using day-night values (day, 11:00 to 16:00 average; night, 02:00 to 07:00 average). Compared with control values, diurnal HR rhythm was abolished on day 1 of high-fat feeding (61.4 +/- 3.6 v 3.1 +/- 4.2 beats/min, respectively; P <or= .05), whereas OC and OH did not differ significantly in day-night HR over 12 weeks. Compared with control values, diurnal BP rhythm was abolished by day 2 of high-fat feeding (4.6 +/- 1.6 v -0.1 +/- 0.9 mm Hg, respectively; P <or= .05), whereas OC and OH did not differ in day-night BP despite lower BP in OH. In this study ad libitum high-fat feeding in rabbits caused immediate losses of diurnal rhythms of BP and HR that were independent of weight gain and BP elevation.

Loss of Diurnal Rhythms of Blood Pressure and Heart Rate Due to High Fat Feeding

Loss of Diurnal Rhythms of Blood Pressure and Heart Rate Due to High Fat Feeding

Daily Rhythms of Blood Pressure, Heart Rate, and Body Temperature in Fed and Fasted Male Dogs

Daily or circadian rhythmicity in physiological processes has been described in a large number of species of birds and mammals. However, in dogs, most studies have either failed to detect rhythmicity or have found that rhythmicity reflects merely an acute exogenous effect of feeding rather than an autonomous rhythmic process. In the present study, we investigated the rhythmicity of body temperature, blood pressure, and heart rate in dogs fed daily as well as in dogs deprived of food for 60 h. Our results document clear rhythmicity in all three parameters and demonstrate that the rhythmicity is independent of the feeding schedule. The failure of various previous investigations to document daily rhythmicity in dogs is probably due to lack of experimental rigour rather than to weakness of daily rhythmicity in dogs.

Suppressed circadian heart rate dynamics in temporal lobe epilepsy

Objectives: To measure interictal circadian rhythm of heart rate (HR) variability in patients with temporal lobe epilepsy (TLE) using a 24 hour ECG recording. Methods: Various conventional and dynamic fractal...

Maternal Fluoxetine Infusion Does Not Alter Fetal Endocrine and Biophysical Circadian Rhythms in Pregnant Sheep

Depression during pregnancy is frequently treated with the selective serotonin reuptake inhibitor (SSRI), fluoxetine (FX), commonly known as Prozac (Eli Lilly & Co, Indianapolis, IN). FX potentiates serotoninergic neurotransmission and serotonin has been implicated in the regulation of circadian rhythms. We have therefore investigated the effect of chronic administration of FX on maternal and fetal circadian rhythms in sheep. Following an initial bolus dose of 70 mg FX, an 8-day continuous infusion of FX (n = 11, 98.5 microg/kg x d) was performed. Controls (n = 13) were treated with sterile water vehicle only. Maternal and fetal plasma melatonin and prolactin concentrations were determined every 3 hours for 24 hours and then every 6 hours for 24 hours beginning on the fourth day of infusion. FX treatment did not alter either the basal or circadian rhythms of either maternal or fetal plasma melatonin and prolactin concentrations. Fetal cardiovascular and behavioral state parameters were measured continuously. While the incidence of low-voltage (LV) electrocortical (ECOG) activity was significantly reduced in fetuses in the FX group, there was no effect of FX on the diurnal rhythms in fetal arterial pressure, heart rate, breathing movements, or behavioral state. These results show that maternal FX treatment does not result in significant alterations in maternal and fetal hormonal and behavioral circadian rhythms.

Maternal Cigarette-Smoking During Pregnancy Disrupts Rhythms in Fetal Heart Rate

To examine the effects of maternal cigarette smoking during pregnancy on the developing infant's autonomic regulation before the possible effects of parturition and neonatal withdrawal could alter outcome measures. Heart rate variability (HRV) was assessed for 10 min during late gestation for 21 cigarette-exposed (CE) and 22 nonexposed (NE) fetuses. HRV was significantly lower in fetuses whose mothers smoked cigarettes during pregnancy. Spectrum analysis of that variability showed temporally organized rhythms at a frequency similar to rhythms previously found in fetal cyclic motility (approximately .3 cycles per min). Lower powered rhythms--associated with poorer development--at the first, second, and dominant rhythms, as well as lower overall power of the power spectrum, were found for CE fetuses. Pearson correlations showed significant negative correlations between the amount of maternal cigarette smoking during the first trimester of pregnancy and measures of fetal HRV and power of spectral peaks. Results show that CE fetuses have lower HRV and disrupted temporal organization of autonomic regulation before effects of parturition, postnatal adaptation, and possible nicotine withdrawal contributes to differences in infant neurobehavioral function.

Nocturnal hypertension and autonomic dysfunction due to human T-lymphotropic virus type-1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP)

Human T-lymphotropic virus type-1 (HTLV-1)-associated myelopathy (HAM) or tropical spastic paraparesis (TSP) is a rare disorder characterised by slowly progressive spastic paraparesis, sphincter disturbances, and minimal sensory loss occurring in less than 5% of patients infected with HTLV-1. More rarely, and in addition to myelopathy, autonomic dysfunction can occur. Cardiovascular dysautonomia predominantly involves sympathetic nerves [1] and can occur sub clinically to alter normal circadian rhythms of blood pressure (BP) and heart rate (HR) in HAM/TSP patients [2].

Sympathetic activation and tachycardia in lipopolysaccharide treated rats are temporally correlated and unrelated to the baroreflex

The goal of this study was to investigate the sustained sympatho-excitation which occurs in sepsis and which accompanies the fall in blood pressure and to analyze its time-correlation with heart rate and the role of the baro-chemoreflexes. Rats anesthetized with pentobarbital were treated with lipolysaccharide (LPS) 20 mg/kg / 20 min i.v. and mean blood pressure (MBP), heart rate (HR), rectal temperature and renal sympathetic nerve activity (RSNA) were recorded. LPS induced a fall in blood pressure, an increase in HR (+ 20%) and RSNA (+ 355%); the arterial PO 2 and PCO 2 remained stable and the injection was fatal within 4 h. Baroreceptor and chemoreceptor denervation accelerated the fall in MBP but did not change the survival time. Under those conditions; RSNA excitation was slightly more pronounced. During treatment with gallamine and under artificial respiration to avoid possible respiratory changes through the chemoreflex pathway, the effects of LPS remained, except for a decrease in arterial PO 2. Electrolytic lesioning of the nucleus tractus solitarius or blocking the effects of baroreflex efferents by either an α 1 or α 2-adrenoceptor antagonists failed to alter the effects of LPS. After treatment with a β-adrenoceptor antagonist, LPS increased RSNA but not HR and the survival time of the rats shortened. LPS administered i.c. (1 mg/kg) induced, with a short latency, effects comparable to those produced by i.v. injection. Surprisingly, the time correlation between RSNA and HR rhythms persisted when MBP dropped after LPS and moreover it reappeared in baroreceptor denervated rats after LPS. Thus under these conditions of altered baroreflex pathway and LPS induced sympathetic activation, the sympathetic output from the medulla appears to play a role in the correlation between heart rate and sympathetic nerve activity. These data indicate that the marked RSNA activation and the tachycardia are correlated and that the baroreflex and chemoreflex are not inhibited during sepsis but appear to be of minor importance in the sympathetic activation and in the blood pressure modifications.

Development of daily rhythmicity in heart rate and locomotor activity in the human fetus.

BackgroundVery little is known about the perinatal genesis of circadian rhythmicity in the human fetus. Some researchers have found evidence of rhythmicity early on in fetal development, whereas others have observed a slow development of rhythmicity during several years after birth.MethodRhythms of fetal heartbeat and locomotor activity were studied in women with physiological course of pregnancy at 16 to 40 gestational weeks. Observations were conducted continuously for 24 h using the method of external electrocardiography, which provided simultaneous detection of the changes in maternal and fetal heartbeat as well as assessment of daily locomotor activity of the fetus. During the night-time, electroencephalogram, myogram, oculogram and respiration of the mother were registered in parallel with fetal external electrocardiography.ResultsAlthough we found no significant daily rhythmicity in heart rate per se in the human fetus, we developed a new method for the assessment of 24-h fetal cardiotachogram that allowed us to identify daily rhythmicity in the short-term pattern of heart beating. We found that daily rhythmicity of fetal electrocardiogram resembles that of the mother; however, the phase of the rhythm is opposite to that of the mother. "Active" (from 9 a.m. to 2 p.m. and from 7 p.m. to 4 a.m.) and "quiet" (from 4 a.m. to 9 a.m. and from 2 p.m. to 7 p.m.) periods of activity were identified.ConclusionA healthy fetus at gestational age of 16 to 20 weeks reveals pronounced rhythms of activity and locomotion. Absence of distinct rhythmicity within the term of 20 to 24 weeks points to developmental retardation. The "Z"-type fetal reaction, recorded during the "quiet" hours, does not indicate unsatisfactory state, but rather is suggestive of definite reduction of functional levels of the fetal physiological systems necessary for vital activity.

Transient Loss of the Diurnal Rhythms of Fetal Movements, Heart Rate, and Its Variation after Maternal Betamethasone Administration

Antenatal betamethasone administration to enhance fetal lung maturation is associated with transient reductions in fetal heart rate (FHR) variation, breathing, and body movements 2 d after the first dose (d 2). This study examines whether steroid administration affects the natural diurnal rhythms of fetal variables. Sixteen women at 27-32 wk of gestation received two doses of betamethasone 24 h apart. One-hour recordings of FHR, breathing, and body movements were made in the morning, afternoon, and evening of d 2, and again in the morning of d 3. Repeat recordings were obtained at 4-6 d later from 9/16 women. Maternal blood samples were obtained with each recording to determine ACTH and cortisol. No diurnal rhythm was present for FHR, FHR variation, breathing, and body movements on d 2. This resulted from suppression of the expected natural rise in body and breathing movements, and heart rate variation in the course of the day. Suppression of the diurnal rhythm of body movements depended on gestation (R = -0.89; p < 0.01). All variables showed diurnal rhythms 4-6 d later. Maternal ACTH and cortisol diurnal rhythms were completely suppressed on d 2. Four to six days later, the normal diurnal pattern was resumed, although absolute levels of ACTH and cortisol were still suppressed. We conclude that maternal betamethasone administration transiently abolishes the fetal diurnal rhythms of heart rate and its variation, breathing, and body movements.

Ultradian but not Circadian Blood Pressure Rhythms Correlate with Renal Dysfunction in Children with Chronic Renal Failure

Whereas the diurnal fall of BP (dipping) is an important prognostic marker in patients with chronic renal failure (CRF), the integrity of physiologic ultradian (i.e., shorter than 24 h) cardiovascular rhythms in patients with CRF is unknown. Also, the relationship between conventional dipping analysis and Fourier spectral rhythm analysis has not been examined in renal hypertension. The prevalence and dimensions of the circadian and three ultradian (12, 8, and 6 h) cardiovascular rhythms were studied by ambulatory BP monitoring in 214 children (aged 3 to 18 yr) with CRF (stage 2 to 4 chronic kidney disease) and no antihypertensive treatment compared with 938 healthy control subjects, and the relationship of rhythm characteristics to conventional dipping parameters, renal function, proteinuria, and serum electrolytes was assessed. The CRF cohort exhibited significantly reduced amplitudes of the circadian and all ultradian cardiovascular rhythms studied (all P < 0.01). Moreover, all BP and most heart rate rhythms showed significantly delayed acrophases (time of peak; P < 0.01). Whereas conventional BP dipping parameters (day/night difference, day/night ratio) and the 24-h BP amplitude were independent of renal function, the 8-h BP amplitude was positively correlated with GFR (r = 0.3, P = 0.01) and inversely correlated with the urinary protein/creatinine ratio (r = -0.27, P < 0.05), and the 6-h BP amplitude was inversely correlated with proteinuria (r = -0.3, P < 0.02). Children who displayed 24- or 12-h cardiovascular rhythms had significantly lower serum calcium levels than children without these rhythms. In summary, children with CRF display not only blunted circadian but also blunted ultradian cardiovascular rhythms. Ultradian but not circadian rhythms or conventional dipping parameters are quantitatively associated with renal function and proteinuria.

Effects of Three‐Hour Restricted Food Access during the Light Period on Circadian Rhythms of Temperature, Locomotor Activity, and Heart Rate in Rats

The effects of food on biological rhythms may influence the findings of chronopharmacological studies. The present study evaluated the influence of a restricted food access during the rest (light) span of nocturnally active Wistar rats on the 24 h time organization of biological functions in terms of the circadian rhythms of temperature (T), heart rate (HR), and locomotor activity (LA) in preparation for subsequent studies aimed at evaluating the influence of timed food access on the pharmacokinetics and pharmacodynamics of medications. Ten‐wk‐old male Wistar rats were housed under controlled 12:12 h light:dark (LD) environmental conditions. Food and water were available ad libitum, excepted during a 3 wk period of restriction. Radiotelemetry transmitters were implanted to record daily rhythms in T, HR, and LA. The study lasted 7 wk and began after a 21‐d recovery span following surgery. Control baseline data were collected during the first wk (W1). The second span of 3 wk duration (W2 to W4) consisted of the restricted feeding regimen (only 3 h access to food between 11:00 and 14:00 h daily) during the L (rest span) under 12:12 h LD conditions. The third period of 3 wk duration (W5 to W7) consisted of the recovery span with ad libitium normal feeding. Weight loss in the amount of 5% of baseline was observed during W1 with stabilization of body weight thereafter during the remaining 2 wk of food restriction. The 3 h restricted food access during the L rest span induced a partial loss of circadian rhythmicity and the emergence of 12 h rhythms in T, HR, and LA. Return to ad libitum feeding conditions restored circadian rhythmicity in the manner evidenced during the baseline control span. Moreover, the MESORS and amplitudes of the T, HR, and LA 24 h patterns were significantly attenuated during food restriction (p<0.001) and then returned to initial values during recovery. These changes may be interpreted as a masking effect, since T, HR, and LA are known to directly react to food intake. The consequences of such findings on the methods used to conduct chronokinetic studies, such as the fasting of animals the day before testing, are important since they may alter the temporal structure of the organism receiving the drug and thereby compromise findings.

Gender differences in blood pressure and heart rate in spontaneously hypertensive and Wistar‐Kyoto rats

1. In general, premenopausal women are known to have lower blood pressure than men and animal models have shown a similar sexual dimorphism. However, many studies in animals have been performed using anaesthetized or restrained models. Current experiments were conducted to investigate the relationships among resting heart rate, blood pressure and gender in conscious, unrestrained normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR). 2. Biotelemetry transmitters were implanted in 6-month-old animals. Values for heart rate, diastolic blood pressure, systolic blood pressure and pulse pressure were recorded continuously at 10 min intervals after all animals recovered completely from surgery. 3. Normal circadian rhythms in heart rate were found in all rats, with no significant differences among the four groups; the circadian variation in blood pressure was evident in all groups, although much smaller. Heart rate was found to be higher in WKY female rats than in the other three groups. Male WKY rats, male SHR and female SHR had similar heart rates. Male SHR had significantly higher systolic and diastolic blood pressures than female SHR. Male and female WKY rats had similar diastolic blood pressure, but males had slightly higher systolic pressure than females. No significant difference in pulse pressure was found in WKY male and female rats. Male SHR showed significantly higher pulse pressure than female SHR at most times during the day. 4. In conclusion, these results indicate that hypertension is exacerbated in male SHR compared with females under conscious resting conditions and demonstrate that the higher heart rate observed in WKY female rats is not present in the SHR model.

Longitudinal studies on the effect of hypertension on circadian hemodynamic and autonomic rhythms in telemetered rats

This study dealt with the long-term effects of hypertension on circadian rhythms of hemodynamic and cardiovascular autonomic functions in radiotelemetered rats. Blood pressure (BP), heart rate (HR), spontaneous locomotor activity, and respiration.were monitored in spontaneously hypertensive rats (SHRs), a model of human hypertension, from 14 to 27 weeks of age and in Wistar-Kyoto rats (WKY) as controls. Cardiovascular autonomic changes were determined by time-domain analysis of the variability of BP (standard deviation of mean arterial pressure, SDMAP) and HR (standard deviation of R-R intervals, SDRR, and the root mean square of successive differences in R-R intervals, rMSSD). Compared with WKY rats, the 24-hr MAP and SDMAP were higher at week 14 in SHRs and showed stepwise increases over the study duration, suggesting progressive increases in vasomotor sympathetic activity in hypertensive rats. Also, higher SDRR, rMSSD, and activity and lower HR and respiration were demonstrated in SHRs. Normal circadian rhythms (higher dark-time values) of MAP, HR, SDMAP, and SDRR were evident in WKY rats at week 20 and continued thereafter. Compared with WKY rats, the circadian BP and HR patterns were abolished and inverted, respectively, in SHRs. Lower dark-time, compared with light-time, SDMAP values were observed in SHRs that were associated with temporal increases in HR variability indices. These findings demonstrate that hypertension elicits significant alterations in circadian autonomic and hemodynamic profiles. Further, the steady increases in BP, average level and oscillations, in SHRs may explain the reported progressive age-related vascular and cardiac hypertrophy in these rats.

Intravenous amiodarone bolus for treatment of atrial fibrillation in patients with advanced congestive heart failure or cardiogenic shock

The clinical course of patients with advanced organic heart disease is often complicated by the occurrence of atrial fibrillation. Slowing the ventricular rate and, if possible, restoration of normal sinus rhythm is crucial but difficult in the state of decreased ventricular function. We included 78 consecutive patients with atrial fibrillation and heart rate above 135 beats min(-1) in an observational, uncontrolled study in the coronary care unit of a tertiary care center. Thirty-nine patients suffered from advanced congestive heart failure, 26 patients had pulmonary edema, and 13 patients were in cardiogenic shock. All patients were treated with 450 mg amiodarone given as a single intravenous bolus through a peripheral venous access without further infusion. Ventricular heart rate and cardiac rhythm were measured within 30 minutes after drug administration. Cardiac rhythm was monitored for 24 hours. The site of venous access was examined 30 minutes after drug administration and every 6 hours until the needle was removed after a maximum of 48 hours. Twenty-five patients (32%) converted to normal sinus rhythm within 30 minutes. Another 15 (19%) reverted into sinus rhythm during the following 24 hours. Within 30 minutes after amiodarone administration, ventricular heart rate decreased significantly from 152 +/- 12 to 88 +/- 17 (p < 0.0001) beats min(-1) in patients who converted to sinus rhythm and from 157 +/- 14 to 98 +/- 16 beats min(-1) in patients who did not. The degree of reduction in heart rate was similar among patients presenting with exacerbated congestive heart failure, pulmonary edema, or cardiogenic shock. Systolic blood pressure decreased in two patients, from 115 to 80 mmHg and from 130 to 100 mmHg, but was reversible after 10 and 90 minutes respectively without specific intervention. No proarrhythmia or clinical relevant bradycardia was observed, and no inflammation detected at the site of venous access. Amiodarone, given as a single intravenous bolus through a peripheral vein rapidly reduced ventricular rate and was well tolerated in patients with atrial fibrillation, even in the presence of congestive heart failure and cardiogenic shock.

Chronoastrobiology: proposal, nine conferences, heliogeomagnetics, transyears, near-weeks, near-decades, phylogenetic and ontogenetic memories

Chronoastrobiology: proposal, nine conferences, heliogeomagnetics, transyears, near-weeks, near-decades, phylogenetic and ontogenetic memories