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The present quantitative analysis was performed to measure the instantaneous beat-to-beat variance of RR intervals SD 1 , the long term continuous variance of all RR intervals SD 2 and the variation in temporal structure of all RR intervals CCM. Instantaneous changes in RR intervals are mediated by vagal efferent activity, because vagal effects on the sinus node are known to develop faster than sympathetically mediated effects [ 30 , 31 ]. The maximum reduction in SD 1 during atropine infusion compared to baseline values, confirming that SD 1 quantifies the vagal modulation of heart rate, which was also reported by Kamen et.

Similar reduction in CCM value could be observed Table 1 and Figure 3 , which indicates that CCM might correlate the parasympathetic nervous system activity. The lowest value of CCM has also been found during atropine infusion which reduced the parasympathetic activity and reduces instantaneous changes in HRV signal. Reciprocal changes in sympathetic and parasympathetic activity occurs during head-up tilt phase. The RR interval and the high-frequency power of RR intervals decreases during the head up tilt phase as evidence of withdrawal of vagal activity decrease in parasympathetic activity [ 32 — 34 ].

The low-dose transdermal scopolamine patch hyoscine 1. Delivery by transdermal patch substantially increases both baseline and reflexly augmented levels of cardiac parasympathetic activity over 24 hours in normal subjects [ 35 , 36 ]. Both time-domain HRV Mean, SD and frequency domain HRV high frequency power increased to a greater extent during administration of low-dose scopolamine, which indicates the increase in parasympathetic activity [ 26 ]. The increased value of SD1 correlates with increased high frequency power and is supported by the previous study reported by Kamen et.

The increase in CCM value indicates that it reflects the change in parasympathetic activity harmoniously. In this study, we have found that CCM correlates with the parasympathetic activity similar to SD 1 [ 16 ]. In [ 22 ], we have shown that CCM is sensitive to change in temporal structure of the signal irrespective of temporal position of the signal. In that study, we had used simulated RR interval signal to prove our hypothesis.

In line with the previous finding [ 22 ], in this study the relation of CCM with increasing number of shuffled RR intervals has been studied. Therefore, we can conclude that CCM is much more sensitive than SD 1 and SD 2 with respect to change in temporal structure or the change in autocorrelation of the signal which was earlier reported in [ 22 ].

However, it is not possible to determine the value of minimum number of required RR interval for all biomedical application as it will be problem specific rather than a global one. The changes due to surrogating are the highest for CCM in all phases, which might indicate that CCM is a measure of temporal structure of the plot and more sensitive to it than SD 1 and SD 2. Moreover, the change in its value between before and after surrogating is the highest for atropine phase which might indicate the reducing parasympathetic activity and its impact on the temporal structure of the plot better manifest in CCM value.

In atropine phase, since the parasympathetic activity is reduced, variability decreases low SD 1 values which is reflected by substantially linear temporal structure of the plot lower CCM values. After surrogating, the correlation among the signal vanishes and as a result, uncorrelated or random temporal structure increased the CCM value.

Therefore, the difference between original and surrogate value indicates that CCM depends on the correlation properties of the RR interval and it can be used to distinguish the HRV signal from uncorrelated random noise. On the other hand, the sensitivity of CCM decreases with enhancement of parasympathetic activity by scopolamine administration.

However, existence of few zero area patterns does not affect the overall CCM value as it is measured using a moving window of three consecutive points. Further studies of CCM of HRV signal with changes in sympathetic activity may give the complete physiological explanation of CCM with respect to sympathovagal activity. Moreover, due to well published changes in autonomic regulation between men and women and in different age groups [ 37 ], and investigation of gender and age effects on CCM would be of interest in further studies.

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AHK, AV and MP contributed to the development of the new descriptor and participated in the discussion and interpretation of the results. All authors read and approved the final manuscript. Reprints and Permissions. Search all BMC articles Search. Background Heart rate variability HRV is a powerful non-invasive method for analyzing the function of the autonomic nervous system. Figure 1. Full size image. Figure 2. Figure 3. Figure 4.

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Table of Contents

Physiological time-series analysis using approximate entropy and sample entropy. De Vito, S. Galloway, M. Nimmo, P. Maas, J. Effects of central sympathetic inhibition on heart rate variability during steady-state exercise in healthy humans. Clin Physiol Funct Imaging, 22 , pp. Rajendra Acharya, K. Paul Joseph, N. Kannathal, C. Lim, J. Med Biol Eng Comput, 44 , pp. Tulppo, T. Airaksinen, H. Heart rate dynamics during accentuated sympathovagal interaction. HH Medline.

Stein, A.


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