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May 22, 2026Open Access

After full adjustment, the AF-AF group showed a stronger association with elevated PRD (β-coefficient 2.10, 95% CI 1.79-2.41, P < 0.001) than the AF-SR group (β-coefficient 0.36, 95% CI 0.08-0.64, P = 0.011) compared to the SR reference group.

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Why the study?

Does atrial fibrillation alter cardiac autonomic function as assessed by periodic repolarization dynamics and heart rate variability in elderly patients?

Population

2,289 elderly patients from a prospective multicentre study with a 5-min resting ECG recording in sinus…

Comparison

Atrial fibrillation (AF-AF and AF-SR groups) vs Sinus rhythm without history of AF

Design

Cross-sectional

Authors

PHPeter HämmerleJSJohannes SchierKRKonstantinos D. Rizas

Discussion

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Overview

Elevated PRD in AF may heighten arrhythmic risk awareness; leaves open whether it predicts outcomes or guides therapy.

Structured PICO

Does atrial fibrillation alter cardiac autonomic function as assessed by periodic repolarization dynamics and heart rate variability in elderly patients?

P
Population
2,289 elderly patients from a prospective multicentre study (Swiss-AF) with a 5-min resting ECG recording in sinus rhythm (SR) or atrial fibrillation (AF) without pacing. Includes 807 SR patients (mean age 74, 37% female), 932 AF patients with SR ECGs (AF-SR, mean age 70, 31% female), and 550 AF patients with AF ECGs (AF-AF, mean age 75, 24% female).
I
Intervention
Atrial fibrillation (AF-AF and AF-SR groups)
C
Comparator
Sinus rhythm without history of AF (SR reference group)
O
Outcome
Cardiac autonomic function quantified by periodic repolarization dynamics (PRD) and conventional heart rate variability (HRV) parameters from a 5-min resting ECGsurrogate

Atrial fibrillation is associated with increased sympathetic activity, with the greatest impairment observed during active AF, suggesting periodic repolarization dynamics is a useful marker for assessing cardiac autonomic function.

Cite This Study

Hämmerle et al. (2026) studied this question.

synapsesocial.com/papers/6a0ff3c0d674f7c03778ca97https://doi.org/10.48620/97832
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiac autonomic function in elderly patients with and without atrial fibrillation2026
  2. 2Association between ultra-short-term heart rate variability and atrial fibrillation in heart failure population: a protocol for a prospective observational cohort study2025 · 2 citations
  3. 3Postoperative atrial fibrillation: function over fibrosis, prevention needed2026
  4. 4Heart Rate Dynamics During Localized Upper-Extremity Function as a Novel Measure of Cardiac Autonomic Dysfunction: Investigation of Aging- and Disease-Related Alterations2025
  5. 5Insight into the relationship between heart rate and mortality in patients in sinus rhythm with heart failure with preserved ejection fraction2022