Autonomic control of heart rate is well known in adult subjects, but limited data are available on the development of the heart rate control during childhood and adolescence. Continuous 12-lead electrocardiograms were recorded in 1045 healthy children and adolescents (550 females) aged 4 to 19 years during postural manoeuvres involving repeated 10-min supine, unsupported sitting, and unsupported standing positions. In each position, heart rate was measured, and heart rate variability indices were evaluated (SDNN, RMSSD, and high (HF) and low (LF) frequency components were obtained). Quasi-normalized HF frequency components were defined as qnHF = HF/(HF + LF). These measurements were, among others, related to age using linear regressions. In supine position, heart rate decreases per year of age were significant in both sexes but lower in females than in males. In standing position, these decreases per year of age were substantially lowered. RMSSD and qnHF indices were independent of age in supine position but significantly decreased with age in sitting and standing positions. Correspondingly, LF/HF proportions showed steep increases with age in sitting and standing positions but not in the supine position. The study suggests that baseline supine parasympathetic influence shows little developmental changes during childhood and adolescence but that in young children, sympathetic branch is less responsive to vagal influence. While vagal influences modulate cardiac periods in young and older children equally, they are less able to suppress the sympathetic influence in younger children.

• MeSH
• autonomní nervový systém * fyziologie   MeSH
• dítě MeSH
• dospělí MeSH
• elektrokardiografie metody   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• postura těla fyziologie   MeSH
• předškolní dítě MeSH
• srdeční frekvence * fyziologie   MeSH
• supinační poloha MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Impaired autonomic modulation and baroreflex sensitivity (BRS) have been reported during and after COVID-19. Both impairments are associated with negative cardiovascular outcomes. If these impairments were to exist undetected in young men after COVID-19, they could lead to negative cardiovascular outcomes. Fatigue is associated with autonomic dysfunction during and after COVID-19. It is unclear if fatigue can be used as an indicator of impaired autonomic modulation and BRS after COVID-19. This study aims to compare parasympathetic modulation, sympathetic modulation, and BRS between young men who had COVID-19 versus controls and to determine if fatigue is associated with impaired autonomic modulation and BRS. Parasympathetic modulation as the high-frequency power of R-R intervals (lnHFR-R), sympathetic modulation as the low-frequency power of systolic blood pressure variability (LFSBP), and BRS as the -index were measured by power spectral density analysis. These variables were compared between 20 young men who had COVID-19 and 24 controls. Independent t-tests and Mann-Whitney U tests indicated no significant difference between the COVID-19 and the control group in: lnHFR-R, P=0.20; LFSBP, P=0.11, and -index, P=0.20. Fatigue was not associated with impaired autonomic modulation or BRS. There is no difference in autonomic modulations or BRS between young men who had COVID-19 compared to controls. Fatigue did not seem to be associated with impaired autonomic modulation or impaired BRS in young men after COVID-19. Findings suggest that young men might not be at increased cardiovascular risk from COVID-19-related dysautonomia and impaired BRS.

• MeSH
• autonomní nervový systém MeSH
• baroreflex fyziologie   MeSH
• COVID-19 * MeSH
• kardiovaskulární systém * MeSH
• krevní tlak fyziologie   MeSH
• lidé MeSH
• srdeční frekvence fyziologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Atrioventricular (AV) conduction turbulence, biphasic dromotropic response of AV node to single ventricular premature contraction (VPC), consists of early shortening and later prolongation of AV conduction intervals due to the direct electrophysiological mechanisms and perturbation in autonomic modulation. We investigated the acute effect of radiofrequency catheter ablation of slow pathway on AV turbulence. METHODS: The electrophysiological study was performed in 18 patients (7 men, mean age 49 ± 15 years) undergoing catheter ablation for AV nodal reentrant tachycardia. The stimulation protocol consisting of series of isolated VPC (coupling interval of 273 ± 23 ms) delivered from right ventricle apex during constant atrial pacing at 100 bpm was performed immediately prior to and 8 ± 4 min after successful slow-pathway ablation. Averaged post-VPCs profiles of AV conduction intervals were analyzed by purpose-written software. The descriptors of AV turbulence, turbulence onset (TOAV), turbulence slope (TSAV), and AV recovery (R AV) were assessed. RESULTS: Slow-pathway ablation suppressed the AV nodal responsiveness to VPC as evidenced by significant reduction of AV turbulence indices: TOAV: -6.4 ± 7.5 % vs. -4.3 ± 6.1 % (p < 0.05); TSAV: 2.0 ± 2.6 ms/RRi vs. 1.0 ± 0.7 ms/RRi (p < 0.05); and R AV: -13.8 ± 7.3 % vs. -6.5 ± 12.7 % (p < 0.05). CONCLUSIONS: Slow-pathway ablation significantly attenuated both vagal and non-autonomic modulation of AV nodal conduction. This effect is likely due to direct thermal injury of AV node associated with the change of properties of AV nodal fast-pathway although specific alteration of peri-AV nodal ganglionated plexi or their neural inputs into the AV node cannot be excluded.

• MeSH
• atrioventrikulární nodální reentry tachykardie patofyziologie   chirurgie   MeSH
• autonomní nervový systém patofyziologie   MeSH
• elektrokardiografie MeSH
• katetrizační ablace * MeSH
• lidé středního věku MeSH
• lidé MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: During atrial fibrillation ablations using thermal energy, the treatment effect is attributed to not just pulmonary vein isolation (PVI), but also to modulation of the autonomic nervous system by ablation of cardiac ganglionated plexi (GP). OBJECTIVES: This study sought to assess the impact of pulsed field ablation (PFA) on the GP in patients undergoing PVI. METHODS: In the retrospective phase, heart rate was assessed pre- versus post-PVI using PFA, cryoballoon ablation, or radiofrequency ablation. In the prospective phase, a pentaspline PFA catheter was used in a protocol: 1) pre-PFA, high-frequency stimulation (HFS) identified GP sites by vagal effects; 2) PVI was performed assessing for repetitive vagal effects over each set of PF applications; 3) mapping defined PVI extent to identify those GP in the ablation zone; and 4) repeat HFS at GP sites to assess for persistence of vagal effects. RESULTS: Between baseline and 3 months, heart rates in the retrospective radiofrequency ablation (n = 40), cryoballoon (n = 40), and PFA (n = 40) cohorts increased by 8.9 ± 11.4, 11.1 ± 9.4, and -0.1 ± 9.2 beats/min, respectively (P= 0.01 PFA vs radiofrequency ablation; P= 0.01 PFA vs cryoballoon ablation). In the prospective phase, pre-PFA HFS in 20 additional patients identified 65 GP sites. During PFA, vagal effects were noted in 45% of first PF applications, persisting through all applications in 83%. HFS post-PFA reproduced vagal effects in 29 of 38 sites (76%) in low-voltage tissue. CONCLUSIONS: PFA has minimal effect on GP. Unlike with thermal ablation, the mechanism by which PFA treats atrial fibrillation is mediated solely by durable PVI.

• MeSH
• fibrilace síní * MeSH
• katetrizační ablace * škodlivé účinky   MeSH
• lidé MeSH
• nervus vagus chirurgie   MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• elektrofyziologie metody   MeSH
• lidé MeSH
• myokard MeSH
• postura těla fyziologie   MeSH
• srdce fyziologie   MeSH
• srdeční frekvence fyziologie   MeSH
• Check Tag
• lidé MeSH

If the eyes are windows into the soul, then the pupils represent at least the gateway to the brain and can provide a unique insight into the human mind from several aspects. The changes in the pupil size primarily mediated by different lighting conditions are controlled by the autonomic nervous system regulated predominantly at the subcortical level. Specifically, parasympathetically-linked pupillary constriction is under the Edinger-Westphal nucleus control and sympathetically-mediated pupillary dilation is regulated from the posterior hypothalamic nuclei. However, the changes in the pupil size can be observed at resting state even under constant lighting, these pupillary changes are mediated by global arousal level as well as by various cognitive factors. In this context, autonomic pathways modulating changes in the pupil size in response to the different light levels can be influenced by multiple central descending inputs driving pupillary changes under steady lighting conditions. Moreover, as the pupillary response is involved in emotional (task-evoked pupillary dilation as an index of emotional arousal) and cognitive (task-evoked pupillary dilation as an index of cognitive workload) stimulation, it can be used to detect the impact of mutual subcortical and cortical structures (i.e. overlapping brain structures included in autonomic, emotional and cognitive regulation) on the pupillary innervation system. Thus, complex understanding of the baseline pupil size ́ and pupillary dynamics ́ mechanisms may provide an important insight into the central nervous system functioning pointing to the pupillometry as a promising tool in the clinical application.

• MeSH
• arousal fyziologie   MeSH
• autonomní nervový systém fyziologie   MeSH
• emoce * MeSH
• kognice fyziologie   MeSH
• lidé MeSH
• pupila * fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Tento přehledový článek se podrobně zabývá mechanismy autonomní regulace kardiovaskulárního systému během spánku, během jednotlivých i opakovaných apnoických pauz, jejich úlohy v patogenezi fibrilace síní (FS) a upozorňuje na metody autonomní modulace. Dysfunkce autonomní regulace kardiovaskulárního systému představuje v podmínkách jednorázové nebo chronické expozice obstrukční spánkové apnoe jeden z hlavních faktorů umožňujících vznik FS a její recidivy. Vrátit do fyziologického stavu autonomní regulaci a příznivě ovlivnit substrát vedoucí k rozvoji a progresi arytmie může kombinace různých způsobů ovlivňování rizikových faktorů vzniku FS (jejich úprava, léčba kontinuálním přetlakem v dýchacích cestách, farmakoterapie a intervenční metody).

This review examines in detail the mechanisms of cardiovascular autonomic control in the course of sleep, during single and multiple repetitive episodes of apnea, their role in pathogenesis of atrial fibrillation (AF), and also highlights the methods of autonomic modulation. In conditions of a single or chronic exposure to obstructive sleep apnea, cardiovascular autonomic dysfunction is one of the leading factors providing the possibility of AF development and recurrence. A combined effect on AF risk factors (their modification, use of continuous positive airway pressure therapy, drug therapy, and interventional techniques) can normalize the autonomic control and positively affect the substrate leading to the development and progression of arrhythmia.

• MeSH
• autonomní nervový systém MeSH
• fibrilace síní * etiologie   MeSH
• kardiovaskulární systém MeSH
• lidé MeSH
• obstrukční spánková apnoe * komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

AIM: The aim of this study was to assess relationships between cardiac autonomic regulation after exercise and different types of single-bout exercise of a maximal intensity and of a similar duration. METHODS: The study group consisted of 30 males (23 ± 2 year old), which was separated into three subgroups. Groups A and B performed exercise interventions (continuous or intermittent), while group C represented the control group. Heart rate variability (HRV) was monitored continuously over 30 min after the exercise and consequently during a 6 h period following intervention. Spectral analysis parameters of HRV (total [PT], low- [PLF], high- [PHF] frequency power, LF/HF, and PLF in normalized units [LFnu]) were determined over 5 min intervals. Heart rate recovery (HRR) was also analysed. RESULTS: There were not significant differences between groups A and B for the entire HRV monitoring (P<0.05) or in the relatively expressed HRR. The cardiac autonomic modulation expressed by PT, PLF, and PHF fully recovered in 120 min after exercise, whereas LF/HF and LFnu did not significantly differ (P<0.05) from the control group 60 min earlier. CONCLUSION: Cardiac autonomic recovery after all-out exercise is type non-dependent and sympathovagal balance restores faster than the absolute HRV magnitude.

• MeSH
• autonomní nervový systém fyziologie   MeSH
• časové faktory MeSH
• dospělí MeSH
• elektrokardiografie MeSH
• lidé MeSH
• mladý dospělý MeSH
• následné studie MeSH
• srdeční frekvence fyziologie   MeSH
• tolerance zátěže fyziologie   MeSH
• zátěžový test metody   MeSH
• zdraví dobrovolníci pro lékařské studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

NTRODUCTION: Late heart rate deceleration parallels the increase of systolic blood pressure during heart rate turbulence (HRT) after ventricular premature complexes (VPC). This is consistent with the involvement of baroreflex mechanism. Physiological background of systolic blood pressure dynamics is not known. Enhanced sympathetic activation and nonautonomic post-VPC changes of stroke volume have been speculated on. METHODS AND RESULTS: We studied 28 subjects (aged 56 +/- 11 years; 20 males; 18 normal and 10 abnormal left ventricular (LV) function) with spontaneous occurrence of VPCs. HRT indices and baroreflex sensitivity were analyzed from the ECGs and finger arterial pressure recordings during 30 minutes of spontaneous respiration in supine position. Beat-by-beat stroke volume and peripheral vascular resistance were computed by a nonlinear, self-adaptive model of aortic input impedance (Modelflow, Finapres Medical Systems, Arnhem, The Netherlands). Indices of HRT and baroreflex sensitivity were highly correlated. In patients with preserved LV function, there was no substantial dynamics of stroke volume in the late phase after VPC, while peripheral vascular resistance increased significantly. In patients with impaired LV function, potentiated first sinus beat after VPC triggered transient hemodynamic alternans. Dynamics of peripheral vascular resistance was attenuated and stroke volume was depressed in the late phase after VPC. CONCLUSIONS: Delayed sympathetically mediated vasomotor response to VPC produces systolic blood pressure overshoot. This subsequently induces vagally mediated late heart rate deceleration. Under physiologic conditions, there is no evidence of other hemodynamic and/or mechanical effect outside the autonomic reflex arch. In patients with LV dysfunction, both depressed vagal and sympathetic modulation and, indirectly, enhanced postextrasystolic potentiation account for attenuated HRT.

• MeSH
• analýza rozptylu MeSH
• autonomní nervový systém patofyziologie   MeSH
• baroreflex fyziologie   MeSH
• cévní rezistence fyziologie   MeSH
• elektrokardiografie MeSH
• financování organizované MeSH
• komorové extrasystoly patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• regresní analýza MeSH
• srdeční frekvence fyziologie   MeSH
• tepový objem fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

BACKGROUND: The main objective of the present cross-sectional cohort study was to determine whether there is an association between cardiac autonomic regulation, as expressed through heart rate variability (HRV), and cardiorespiratory fitness (CRF), visceral adipose tissue (VAT), and over the long-term living in areas with low or high air pollution. METHODS: The study sample included 1036 (487 females) healthy runners (603) and inactive participants (age 18-65 years) who had lived for at least 5 years in an area with high (Moravian-Silesian; MS) or low (South Bohemian; SB) air pollution in the Czech Republic. A multivariable regression analysis was used to evaluate the associations between multiple independent variables (CRF (peak oxygen consumption), VAT, sex, socioeconomic status (education level), and region (MS region vs. SB region) with dependent variable HRV. The root mean square of successive RR interval differences (rMSSD) was employed for the evaluation of HRV. RESULTS: The multivariable linear regression model revealed that cardiac autonomic regulation (rMSSD) was significantly associated with CRF level (p < .001) and age (p < .001). There were no associations between rMSSD and region (high or low air-pollution), sex, education level or VAT (p > 0.050). CONCLUSIONS: We showed that living in an area with low or high air pollution is not associated with cardiac autonomic modulation in healthy runners and inactive individuals. CRF and age significantly directly and inversely, respectively, associated with HRV. There were no other significant associations.

• MeSH
• autonomní nervový systém fyziologie   MeSH
• dospělí MeSH
• kardiorespirační zdatnost * fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nitrobřišní tuk * MeSH
• průřezové studie MeSH
• senioři MeSH
• srdce fyziologie   MeSH
• srdeční frekvence * fyziologie   MeSH
• znečištění ovzduší * škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH