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Bisoprolol-induced changes in the spectral characteristics of heart rate variability in patients with atrial fibrillation: a clinical case

DOI: https://doi.org/10.29296/25877305-2020-03-07
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E. Popova(1), Candidate of Biological Sciences; Professor O. Bogova(2), MD; Professor S. Puzin(1)-3, MD; Academician of the Russian Academy of Sciences; Honored Scientist of the Russian Federation, Professor D. Sychev(2), MD; Corresponding Member of the Russian Academy of Sciences; Professor V. Fisenko(1), MD; Academician of the Russian Academy of Sciences (1)I.M. Sechenov First Moscow State Medical University (Sechenov University) (2)Russian Medical Academy of Continuing Postgraduate Education, Moscow (3)Federal Research and Clinical Center for Reanimatology and Rehabilitology, Village of Lytkino, Rural Settlement of Sokolovskoye, Moscow Region

Spectral analysis of heart rate variability (HRV) can judge the autonomic regulation of myocardial chronotropic function. Medicines can significantly change the spectral HRVs, suggesting that there is a change in cardiac autonomic regulation during drug therapy. Objective. To investigate the effect of the β-blocker bisoprolol on the spectral parameters of HRV in patients with atrial fibrillation (AF). Subjects and methods. The spectral parameters of HRV were investigated in patients with both newly diagnosed AF and its 6-month to 8-year history, who were treated with oral bisoprolol 2.5-5.0 mg. The total power of the HRV spectrum and the fluctuation power of very low frequencies (VLF), low frequencies (LF), and high frequencies (HF) were calculated. Results. The proportion of slow fluctuations (LF) in the newly-diagnosed AF group was shown to be twice lower than that in the long-term AF group, and the proportion of fast fluctuations (HF) was twice higher. This suggests that a major role in the regulation of chronotropic cardiac function is played by the vagus nerve in bisoprol-treated patients with newly diagnosed AF and by the sympathetic nervous system in patients with long-term AF, Conclusion. Drug therapy for AF changes the spectral parameters of HRV and cardiac autonomic regulation. Selecting drug therapy in terms of the clinical type of AF in an individual and a patient’s autonomic status makes it possible to enhance therapeutic effectiveness.

spectral analysis of heart rate variability
atrial fibrillation

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