Autonomic Nerve Modulation Demonstrated by Tilt Table Test in Paroxysmal Atrial Fibrillation

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Background: The role of autonomic nerve function (ANF) modulation in genesis of atrial fibrillation is still unclear. This study was aimed to evaluate the modulation of ANF in paroxysmal atrial fibrillation (PAF) patient by using tilt table test. Methods: This study enrolled 27 healthy adults (13 F, mean age 46±8 years) as control group (CG) and 14 patients with PAF (8 F, mean age 51±7 years) as PAF group (FG). The tilt table test was performed during sinus rhythm with the following protocol: 1. 10 minutes resting baseline 2. 10 minutes 70 degree 3. 10 minutes flat position. Results: In resting baseline, there were no differences between the CG and FG. After tilting, the normalized HRV low frequency component (LF-HRV, 65±13% vs 51±16, p<0.001), and the ratio of diastolic blood pressure variability low frequency component over the HRV high frequency component (LFHF, 2±1.4 vs 1±0.6% to, p<0.001) were significantly increased in the CG but not in the FG. Besides, in tilting stage, the LF-HRV (47±21 vs 65±13%; P=0.002), LFHF (1±0.9 vs 2±1.4, P=0.02) and normalized HRV high frequency component (54±21 vs 35±14%, P=0.002) were significant different in FG. Conclusions: The remodeling of ANF could be demonstrated easily by tilt table test in patient with PAF.