Nonlinear Heart Rate Dynamics Before and After Paroxysmal Atrial Fibrillation Events

Ting Wei Ernie Liao, Li Wei Lo*, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Fa Po Chung, Tze Fan Chao, Jo Nan Liao, Hui Wen Yang, Men Tzung Lo, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Heart rate complexity, derived from nonlinear heart rate variability (HRV), has been shown to help predict the outcomes of various diseases. Changes in heart rate complexity before and after paroxysmal atrial fibrillation (PAF) events are unclear. Objectives: To evaluate changes in heart rate complexity through nonlinear HRV before and after PAF events. Methods: We enrolled 65 patients (72 ± 12.34 years old, 31 females) with 99 PAF events who received 24-hour Holter recording, and analyzed nonlinear HRV variables including Poincaré plot analysis, sample entropy (SampEn), and multiscale entropy (MSE). HRV analyses were applied to a 20-minute window before the onset and after the termination of PAF events. HRV parameters were evaluated and compared based on eight different 5-minute time segments, as we divided each 20-minute window into four segments of 5 minutes each. Results: SampEn and MSE1~5 significantly decreased before the onset of PAF events, whereas SampEn, MSE1~5 and MSE6~20 significantly increased after the termination of PAF events. SD1 and SD2, which are nonlinear HRV parameters calculated via Poincaré plot analysis, did not significantly change before the PAF events, however they both decreased significantly after termination. Conclusions: Heart rate complexity significantly decreased before the initiation and increased after the termination of PAF events, which indicates the crucial role of nonlinear heart rate dynamics in the initiation and termination of PAF.

Original languageEnglish
Pages (from-to)594-600
Number of pages7
JournalActa Cardiologica Sinica
Issue number5
StatePublished - Sep 2022


  • Atrial fibrillation
  • Heart rate complexity
  • Heart rate variability
  • Multiscale entropy
  • Nonlinear heart rate variability
  • Poincaré plot analysis


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