Heart rate variability (HRV) is the difference between the successive changes in the heartbeat cycle, and it is produced in the autonomic nervous system modulation of the sinus node of the heart. The HRV is a valuable indicator in predicting the sudden cardiac death and arrhythmic events. Traditional analysis of HRV is based on a multielectrocardiogram (ECG), but the ECG signal acquisition is complex, so we have designed an HRV analysis system based on photoplethysmography (PPG). PPG signal is collected by a microcontroller from human's finger, and it is sent to the terminal via USB-Serial module. The terminal software not only collects the data and plot waveforms, but also stores the data for future HRV analysis. The system is small in size, low in power consumption, and easy for operation. It is suitable for daily care no matter whether it is used at home or in a hospital.
Autonomic Nervous System ; physiopathology ; Cardiovascular Diseases ; diagnosis ; Death, Sudden, Cardiac ; Electrocardiography ; Heart Rate ; Humans ; Monitoring, Ambulatory ; instrumentation ; Photoplethysmography ; instrumentation ; Sinoatrial Node ; physiopathology ; Software

OBJECTIVE: To investigate the expression of hyperpolarization-activated cyclic nucleotide-gated cation channel 4 (HCN4) and connexin43 (Cx43) in the sinoatrial node of electric shock death. METHODS: As experimental group, 34 cases of electric shock death who had definite current mark evidence were selected from pathology department of Xuzhou Medical College from 2010 to 2013. As the control group, 20 cases of fatal severe craniocerebral injury in traffic accidents were chosen. The expressions of HCN4 and Cx43 in the sinoatrial node were observed by immunohistochemical technology. RESULTS: HCN4 positive cells expressed in the cell membrane and cytoplasm of the sinoatrial node. Cx43 positive cells expressed in the cell membrane and cytoplasm of T cells and myocardial cells. The expression of HCN4 was significantly higher than that of the control group (P < 0.05) and the expression of Cx43 was significantly lower than that of the control group (P < 0.05). CONCLUSION The changes of HCN4 and Cx43 expressions in the sinoatrial node illustrate electric shock death might be related to the abnormalities of cardiac electrophysiology and conduction.
Connexin 43/metabolism* ; Cyclic Nucleotide-Gated Cation Channels ; Heart Rate ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels/metabolism* ; Immunohistochemistry/methods* ; Myocardium/metabolism* ; Myocytes, Cardiac ; Sinoatrial Node/physiopathology*

The early cardiac biological pacemaker studies were mostly around HCN channel, and how to build a biological pacemaker through the enhanced If current. In recent years, however, people found that the genes of Tbx3 could play an important role in the development of cardiac conduction system, especially in processes of the maturity of the sinoatrial node and maintenance of its function. And the Tbx3 can further optimize the biological pacemaker. Therefore, it could be a new therapeutic focus in biological pacemaker and treatment of cardiac conduction system disease. This paper summarizes some of the latest research progress of the Tbx3 in biological pacemaker in recent years. We hope that this review could provide theoretical basis for the clinical applications of Tbx3.
Arrhythmias, Cardiac ; genetics ; Biological Clocks ; Brugada Syndrome ; Cardiac Conduction System Disease ; Heart ; physiopathology ; Heart Conduction System ; abnormalities ; Humans ; Sinoatrial Node ; T-Box Domain Proteins ; genetics

OBJECTIVETo observe the changes of surface ECG and cell couplings between sinoatrial node cells and myocardial cells following transplantion of pedicled autologous sinoatrial node tissue graft into the right ventricle of a canine model of complete atrioventricular block.

METHODSTen healthy dogs were randomized into transplantation group and control group. Pedicled autologous sinoatrial node tissue grafts were transplanted into the right ventricle in the transplantation group, while the sinoatrial nodes were only excised in the control group after placement of temporary myocardial pacing wires. The changes of surface ECG were observed at 1, 2, 3 and 4 weeks postoperatively. At 4 weeks, complete atrioventricular block was induced in the dogs by radiofrequency ablation of the His bundle. The heart rate of the dogs in both groups were recorded after the injection of isoproternol (ISO) from the femoral vein, and the transplanted tissue graft was observed under optical and transmission electron microscopes.

RESULTSNo significant changes occurred in the surface ECG. All the dogs showed ECG waveforms specific of complete heart block after the ablation, and the ventricular heart rates were similar between the two groups (P>0.05). The ventricular heart rate did not undergo obvious changes after ISO injection (P>0.05). The transplanted pedicled autologous sinoatrial node survived in the dogs and the sinoatrial node cells established desmosome junctions with the myocardial cells, but the number of junctions was not sufficient to support heart pacing.

CONCLUSIONDesmosome junction can occur between ventricular myocardial cells and sinoatrial node cells at the edge of transplanted pedicled autologous sinoatrial node tissue.

Animals ; Atrioventricular Block ; physiopathology ; surgery ; Cardiotonic Agents ; pharmacology ; Dogs ; Electrocardiography ; Female ; Heart Rate ; drug effects ; Heart Ventricles ; surgery ; Intercellular Junctions ; Isoproterenol ; pharmacology ; Male ; Myocardium ; cytology ; Sinoatrial Node ; cytology ; transplantation ; Tissue Transplantation ; Transplantation, Autologous

The study was aimed to assess the effect of Klotho gene and sinoatrial node pacing channel gene (HCN4 and HCN2) for studying sick sinus syndrome, with Klotho gene under the interference of Plasmid-mediated short hairpin RNA. Twenty-five C57BL/6J mice were divided into four groups, i. e, plasmid shRNA 24h group, plasmid shRNA 12h group, sodium chloride 24h group and sodium chloride 12h group. Plasmid shRNA 50microL (1microg/microL) and sodium chloride 50microl were respectively injected according to mice vena caudalis into those in plasmid shRNA group and sodium chloride group. After 12h or 24h respectively, all mice were executed and their sinoatrial node tissues were cut. The mRNA of Klotho, HCN4 and HCN2 gene were detected by RT-PCR. The results of RT-PCR showed that Klotho, HCN4 and HCN2 mRNA levels were lower compared with those in sodium chloride 12h group after 12h interference interval. The results indicated that there might be the a certain relationship between Klotho gene and sinoatrial node pacing channel gene.
Animals ; Glucuronidase ; genetics ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels ; genetics ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Plasmids ; genetics ; Potassium Channels ; genetics ; metabolism ; RNA Interference ; RNA, Messenger ; genetics ; metabolism ; RNA, Small Interfering ; genetics ; Sinoatrial Node ; metabolism ; physiology ; physiopathology

OBJECTIVETo study the effect of Kangxin Fulu Recipe (KFR) on electrophysiological functions of the sinoatrial node in rabbits with sick sinus syndrome (SSS).

METHODSSixty big ears white rabbits were randomly divided into six groups, i.e., the normal group, the model group, the atropine group, the high dose KFR group, the middle dose KFR group, and the low dose KFR group, ten in each group. SSS model was established by injecting formaldehyde to the sinoatrial node except those in the normal group. Changes in AA interval, the sinoatrial conduction time (SACT), the sinus node recovery time (SNRT), and the corrected sinus node recovery time (CSNRT) were measured before and after modeling, seven days before and after gastrogavage.

RESULTS(1) The AA interval and SACT could be significantly shortened in the high dose KFR group, the middle-dose KFR group, and the atropine group (P<0.05, P<0.01). Better effects were obtained in the former two groups (P<0.05). (2) SNRT and CSNRT could be shortened in the high dose KFR group and the atropine group, with no statistical difference between the two groups (P>0.05).

CONCLUSIONThe electrophysiological mechanism of KFR might possibly be correlated with accelerating the recovery of sinus node autorhythmicity and conduction functions.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Heart Rate ; drug effects ; Rabbits ; Sick Sinus Syndrome ; physiopathology ; Sinoatrial Node ; drug effects ; physiopathology

Recent evidence indicates that the voltage clock (cyclic activation and deactivation of membrane ion channels) and Ca2+ clocks (rhythmic spontaneous sarcoplasmic reticulum Ca2+ release) jointly regulate sinoatrial node (SAN) automaticity. However, the relative importance of the voltage clock and Ca2+ clock for pacemaking was not revealed in sick sinus syndrome. Previously, we mapped the intracellular calcium (Cai) and membrane potentials of the normal intact SAN simultaneously using optical mapping in Langendorff-perfused canine right atrium. We demonstrated that the sinus rate increased and the leading pacemaker shifted to the superior SAN with robust late diastolic Cai elevation (LDCAE) during beta-adrenergic stimulation. We also showed that the LDCAE was caused by spontaneous diastolic sarcoplasmic reticulum (SR) Ca2+ release and was closely related to heart rate changes. In contrast, in pacing induced canine atrial fibrillation and SAN dysfunction models, Ca2+ clock of SAN was unresponsiveness to beta-adrenergic stimulation and caffeine. Ryanodine receptor 2 (RyR2) in SAN was down-regulated. Using the prolonged low dose isoproterenol together with funny current block, we produced a tachybradycardia model. In this model, chronically elevated sympathetic tone results in abnormal pacemaking hierarchy in the right atrium, including suppression of the superior SAN and enhanced pacemaking from ectopic sites. Finally, if the LDCAE was too small to trigger an action potential, then it induced only delayed afterdepolarization (DAD)-like diastolic depolarization (DD). The failure of DAD-like DD to consistently trigger a sinus beat is a novel mechanism of atrial arrhythmogenesis. We conclude that dysfunction of both the Ca2+ clock and the voltage clock are important in sick sinus syndrome.
Animals ; Arrhythmia, Sinus/physiopathology ; Atrial Fibrillation/physiopathology ; Bradycardia/physiopathology ; Calcium/*physiology ; Calcium Channels/*physiology ; Dogs ; Humans ; Sick Sinus Syndrome/physiopathology ; Sinoatrial Node/physiology/*physiopathology

This paper aims to find a new method of detecting atrial fibrillation (AF) with fast responding speed and high detecting precision by R-R intervals. Probability density function (PDF) of distance between two points in the reconstructed phase space of R-R intervals of normal sinus rhythm (NSR) and AF is studied. It is found that the distribution of PDF between NSR and AF R-R intervals is significantly different; and based on this finding, a characteristic parameter k is defined. k is used for defection among 400 NSR and 400 AF R-R intervals. The results demonstrate that the new algorithm has fast responding speed and high detecting precision (average sensitivity 97.0%, average specificity 95.2%).
Algorithms ; Atrial Fibrillation ; diagnosis ; physiopathology ; Diagnosis, Differential ; Electrocardiography ; Humans ; Signal Processing, Computer-Assisted ; Sinoatrial Node ; physiopathology

OBJECTIVETo study the effect of the Chinese medicine Qiangxin Fumai Granule (, QFG) on electrophysiological functions of the sinoatrial node during ischemia-reperfusion (IR) of the right coronary artery in rabbits.

METHODSThe right coronary artery IR model in rabbits was adopted. The modeled rabbits were randomly divided into 4 groups: the model group, the atropine group, the high-dose QFG group, and the low-dose QFG group, with 8 animals in each group. In addition, twelve rabbits were selected for the sham-operative group. The drugs were administered once via duodenal perfusion after modeling had been stabilized for 10 min. The changes in AA interval, the sinoatrial conduction time (SACT), the sinus node recovery time (SNRT), the corrected sinus node recovery time (CSNRT) and the index of sinus node recovery time (ISNRT) at different time points during ischemia and reperfusion were measured.

RESULTSThe AA interval was prolonged for more than 40 ms in the model group during ischemia. Compared with the model group, the four electrophysiological parameters abovementioned in the high-dose QFG group and the low-dose QFG group were decreased to different extents at each time point (P<0.01 or P<0.05), and no statistically significant differences were found between the QFG groups and the atropine group (P>0.05).

CONCLUSIONQFG is beneficial for accelerating the recovery of sinus node autorhythmicity and conduction function, so as to protect electrophysiological functions of the sinoatrial node. Accelerating the recovery of autorhythmicity and conduction function in the sinus node is considered its electrophysiological mechanism in the treatment of sinoatrial node injury induced by ischemia.

Animals ; Coronary Vessels ; drug effects ; physiopathology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Electrophysiological Phenomena ; drug effects ; Heart Conduction System ; drug effects ; Myocardial Reperfusion Injury ; drug therapy ; physiopathology ; Phytotherapy ; Rabbits ; Sinoatrial Node ; drug effects ; physiopathology ; Time Factors

Instantaneous chaometry was defined on uniformity theory constructed by the present authors. The sample data, sinus heart rate data and arrhythmia heart rate data from MIT-BIH were analyzed with instantaneous chaometry (ICM); the situation not being distinguished with HRV can be differentiated with ICM. The normal sinus rhythm was found to be of three evident characteristics: (1) instant returning to zero, (2) stability-stable characteristic of ICM on the initial position, (3) interval of mean: 2-7, variance: 1.5-5. The third characteristic shows that the variability of ICM is necessary. The studies on arrhythmia database showed that arrhythmia cases exhibited no returning to zero, nonstability of ICM on the initial position, too small mean or standard deviation, respectively. Evidently, the arithmetic of ICM is simple; ICM can be easily applied in clinical and pathologic analyses.
Arrhythmias, Cardiac ; physiopathology ; Electrocardiography ; methods ; Heart Rate ; physiology ; Humans ; Male ; Middle Aged ; Signal Processing, Computer-Assisted ; Sinoatrial Node ; physiology