ArticleClinical research in cardiology : official journal of the German Cardiac Society2023
Heart rate variability and atrial fibrillation in the general population: a longitudinal and Mendelian randomization study.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 31 citations in OpenAlex.
- Heart-rate-derived variability measures and in-hospital mortality in critically ill patients with heart failure and atrial fibrillation: insights from the MIMIC-IV database.BMC cardiovascular disorders · 2026Article
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- Remote collaboration in virtual reality induces physiological synchrony comparable to face-to-face interaction.Scientific reports · 2026Article
- Amiodarone-metoprolol co-administration enhances heart rate variability and suppresses inflammatory cytokines in tachyarrhythmia patients.American journal of translational research · 2026Article
- Heart rate variability in patients with atrial fibrillation of sinus rhythm or atrial fibrillation: chaos or merit?Annals of medicine · 2025Review
- Article
- Integrated Diagnostics for Atrial Fibrillation Recurrence: Exploratory Results from the PLACEBO Trial.Diagnostics (Basel, Switzerland) · 2025Article
- Value of routine heart rate variability parameters for atrial fibrillation detection in ischaemic stroke and high-risk TIA patients.Frontiers in stroke · 2025Article
- Gender-specific impact of stress and adiposity on autonomic stress modulation in teachers.Frontiers in psychology · 2025Article
- Exploring the Missing link between vitamin D and autism spectrum disorder: Scientific evidence and new perspectives.Heliyon · 2024Article
- Exploring the impact of electrocardiographic parameters on the risk of common arrhythmias: a two-sample Mendelian randomization study.Journal of thoracic disease · 2024Article
- The relationship between emotional disorders and heart rate variability: A Mendelian randomization study.PloS one · 2024Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundSex differences and causality of the association between heart rate variability (HRV) and atrial fibrillation (AF) in the general population remain unclear.
methods12,334 participants free of AF from the population-based Rotterdam Study were included. Measures of HRV including the standard deviation of normal RR intervals (SDNN), SDNN corrected for heart rate (SDNNc), RR interval differences (RMSSD), RMSSD corrected for heart rate (RMSSDc), and heart rate were assessed at baseline and follow-up examinations. Joint models, adjusted for cardiovascular risk factors, were used to determine the association between longitudinal measures of HRV with new-onset AF. Genetic variants for HRV were used as instrumental variables in a Mendelian randomization (MR) analysis using genome-wide association studies (GWAS) summary-level data.
resultsDuring a median follow-up of 9.4 years, 1302 incident AF cases occurred among 12,334 participants (mean age 64.8 years, 58.3% women). In joint models, higher SDNN (fully-adjusted hazard ratio (HR), 95% confidence interval (CI) 1.24, 1.04-1.47, p = 0.0213), and higher RMSSD (fully-adjusted HR, 95% CI 1.33, 1.13-1.54, p = 0.0010) were significantly associated with new-onset AF. Sex-stratified analyses showed that the associations were mostly prominent among women. In MR analyses, a genetically determined increase in SDNN (odds ratio (OR), 95% CI 1.60, 1.27-2.02, p = 8.36 × 10
conclusionLongitudinal measures of uncorrected HRV were significantly associated with new-onset AF, especially among women. MR analyses supported the causal relationship between uncorrected measures of HRV with AF. Our findings indicate that measures to modulate HRV might prevent AF in the general population, in particular in women. AF; atrial fibrillation, GWAS; genome-wide association study, IVW; inverse variance weighted, MR; Mendelian randomization, MR-PRESSO; MR-egger and mendelian randomization pleiotropy residual sum and outlier, RMSSD; root mean square of successive RR interval differences, RMSSDc; root mean square of successive RR interval differences corrected for heart rate, SDNN; standard deviation of normal to normal RR intervals, SDNNc; standard deviation of normal to normal RR intervals corrected for heart rate, WME; weighted median estimator.
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