Circadian rhythm of the signal averaged electrocardiogram and its relation to heart rate variability in healthy subjects

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Circadian rhythm of the signal averaged electrocardiogram and its relation to heart rate variability in healthy subjects

M Nakagawa,^a T Iwao,^a S Ishida,^a H Yonemochi,^a T Fujino,^a T Saikawa,^b M Ito^a

^a Department of Laboratory Medicine, Oita Medical University, Hasama-machi 1-1, Oita 879-55, Japan, ^b First Department of Internal Medicine, Oita Medical University

Correspondence to: Dr Nakagawa.

Accepted for publication 23 December 1997

Objective $---$ To examine the circadian variation in the signal averaged electrocardiogram (saECG) and heart rate variability and investigatetheir relations in healthysubjects.
Methods $---$ 24 hour ECGs were obtained with a three channel recorder using bipolar X, Y, and Z leads in 20 healthy subjects. The followingvariables were determined hourly: heart rate, filtered QRS (f-QRS)duration, low and high frequency components of heart rate variability(LF and HF), and the LF/HFratio.
Results $---$ Heart rate, f-QRS duration, HF, and the LF/HF ratio showed significant circadian rhythms, as determined by the single cosinormethod. Heart rate and the LF/HF ratio increased during daytime,and f-QRS duration and HF increased at night. f-QRS duration wasnegatively correlated with heart rate (r = 0.95, p < 0.001) andthe LF/HF ratio (r = 0.94, p < 0.001) and positively with HF (r= 0.93, p < 0.001).
Conclusions $---$ f-QRS duration has a significant circadian rhythm in healthy subjects and is closely related to the circadian rhythm of autonomictone.

Keywords: signal averaged ECG; f-QRS duration; circadian rhythm; heart rate variability

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