Vagal modulation of heart rate variability during atrial fibrillation in pigs

Atrial fibrillation (AF) is the most common sustained cardiac dysrhythmia and is associated with an increased risk for sudden cardiac death. The ventricular rhythm is irregular and displays both non-linear and linear patterns; however, it has not been determined whether vagally derived patterns are manifest within the irregular rhythm. Moreover, indices of increased vagal control are associated with reduced risk of sudden cardiac death. In this study, we sought to determine whether the ventricular rhythm pattern during AF is, in part, modulated by vagal activity. Vagal oscillations were forced at 0.15 Hz by neck suction in 12 pigs with sustained AF with and without glycopyrrolate (0.15 μg/kg, intravenously) vagal blockade. Vagal activity was evaluated using time- and frequency-domain heart rate variability measures. The standard deviation of RR intervals (SDRRI) was significantly increased during vagal activation compared with baseline (P = 0.006). Moreover, SDRRI correlated significantly with spectral power at 0.15 Hz during baseline (r = 0.90, P < .001) and vagal activation (r = 0.86, P, 0.05). Glycopyrrolate blocked the increase in SDRRI (P < 0.001) and blunted spectral power at 0.15 Hz (P < 0.05). These results indicate that: (1) power spectral analysis may be used to assess parasympathetic regulation during AF, and (2) vagal oscillations produce an entrainment of the ventricular rhythm during AF in pigs.