Autonomic nervous activity at episodes of myocardial ischemia in patients with coronary artery disease by heart rate power spectral analysis

Heart rate power spectral analysis in 44 patients with coronary artery disease was obtained from 24-hour dynamic electrocardiogram. 195 episodes of transient myocardial ischemia that was defined as horizontal or down sloping depression of the ST segment of > or = 0.1 mV and lasted for > or = 2 minutes were studied. The area of low frequency components (LF, 0.02-0.10 Hz) representing predominontly sympathetic tone with some contribution from the parasympathetic tone and that of high frequency components (HF, 0.15-0.40 Hz) representing mainly parasympathetic tone and the value of LF/HF on 4 minute heart rate power spectral graph at the deepest depression of ST segment were compared with that before the episode of myocardial ischemia. The area of HF of fast rate myocardial ischemia occurring in night reduces significantly (P < 0.001), the value of LF/HF increases markedly (P < 0.05) and the area of LF increases slightly. The results suggest that there is a change of autonomic nervous activity during the episode of fast rate myocardial ischemia in night, parasympathetic nervous tone decreases markedly, there may be secondary increase of sympathetic nervous activity.