High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope

High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope

(1) Background: The autonomic imbalance plays a role in vasovagal syncope (VVS) diagnosed by head-up tilting test (HUT). neuECG is a new method of recording skin electrical signals to simultaneously analyze skin sympathetic nerve activity (SKNA) and electrocardiogram. We hypothesize that SKNA is hig...

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Autores principales: Tien-Chi Huang, Nai-Yu Chi, Chih-Sung Lan, Chang-Jen Chen, Shih-Jie Jhuo, Tsung-Han Lin, Yi-Hsueh Liu, Li-Fang Chou, Chien-Wei Chang, Wei-Sheng Liao, Pei-Heng Kao, Po-Chao Hsu, Chee-Siong Lee, Yi-Hsiung Lin, Hsiang-Chun Lee, Ye-Hsu Lu, Hsueh-Wei Yen, Tsung-Hsien Lin, Ho-Ming Su, Wen-Ter Lai, Wei-Chung Tsai, Shien-Fong Lin, Chien-Hung Lee
Formato: article
Lenguaje:EN
Publicado: MDPI AG 2021
Materias:
skin sympathetic nerve activity
vasovagal syncope
head-up tilting test
heart rate variability
Medicine
R
Acceso en línea:https://doaj.org/article/fa03d66b0d774756b1647d8bc860fd08
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Sumario:(1) Background: The autonomic imbalance plays a role in vasovagal syncope (VVS) diagnosed by head-up tilting test (HUT). neuECG is a new method of recording skin electrical signals to simultaneously analyze skin sympathetic nerve activity (SKNA) and electrocardiogram. We hypothesize that SKNA is higher in subjects with tilt-positive than tilt-negative and the SKNA surges before syncope. (2) Methods: We recorded neuECG in 41 subjects who received HUT (according to the “Italian protocol”), including rest, tilt-up, provocation and recovery phases. Data were analyzed to determine the average SKNA (aSKNA, μV) per digitized sample. Electrocardiogram was used to calculate standard deviation of normal-to-normal beat intervals (SDNN). The “SKNA-SDNN index” was calculated by rest aSKNA multiplied by the ratio of tilt-up to rest SDNN. (3) Results: 16 of 41 (39%) subjects developed syncope. The aSKNA at rest phase is significantly higher in the tilt-positive (1.21 ± 0.27 µV) than tilt-negative subjects (1.02 ± 0.29 µV) (<i>p</i> = 0.034). There are significant surges and withdraw of aSKNA 30 s before and after syncope (both <i>p</i> ≤ 0.006). SKNA-SDNN index is able to predict syncope (<i>p</i> < 0.001). (4) Conclusion: Higher SKNA at rest phase is associated with positive HUT. The SKNA-SDNN index is a novel marker to predict syncope during HUT.

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