Background. To evaluate the changes in autonomic neural control mechanisms before
malignant ventricular arrhythmias, we measured heart rate variability (HRV) and heart rate
turbulence (HRT) in patients with ventricular tachycardia or fibrillation (Group I; n=6), non sustained
ventricular tachycardia (Group II; n=32), frequent premature ventricular beats (Group III;
n=26) and with ICD implantation (Group IV; n=11).
Methods. Time domain parameters of HRV and turbulence onset (TO) and slope (TS) were calculated on 24 hour Holter recordings. Normal values were: SDNN > 70 msec for HRV, TO <0% and TS >2.5 msec/RR-I for HRT.
Results. Whereas SDNN was within normal range and similar in all study groups, HRT parameters were significantly different in patients who experienced VT/VF during Holter recording. Abnormal TO and/or TS were present in 100% of Group I patients and only in about 50% of Group II and IV. On the contrary, normal HRT parameters were present in 40-70% of Group II, III and IV patients and none of Group I.
Conclusions. These data suggest that HRT analysis is more suitable than HRV to detect those transient alterations in autonomic control mechanisms that are likely to play a major trigger role in the genesis of malignant cardiac arrhythmias. (Heart International 2007; 3: 51-7)
Sudden cardiac death, Autonomic nervous system, Risk stratification, Ventricular fibrillation, Holter recordings
Prof. Federico Lombardi, MD, FESC Cardiologia, Dipartimento di Medicina, Chirurgia e Odontoiatria, Osp. San Paolo, Università di Milano, Via A. di Rudinì, 8, 20142 Milano – Italy, Federico.Lombardi@unimi.it
Share this Article
Related Content In Arrhythmia
Radiofrequency Lesion Quality Markers: Current State of Knowledge
European Journal of Arrhythmia & Electrophysiology. 2022;8(1):2-6 DOI: https://doi.org/10.17925/EJAE.2022.8.1.2
Radiofrequency (RF) ablation involves delivering medium-to-high-frequency alternating current, which is electrically conducted to cardiac tissue that constitutes a part of the circuit. The unipolar circuitry contains the generator, transmission lines, catheter, cardiac tissue, interposed tissue and dispersive electrode (ground pad/indifferent electrode). Bipolar systems, whereby the RF current flows between two electrodes, either on the same […]
Remote Monitoring of Cardiac Arrhythmias Using Wearable Digital Technology: Paradigm Shift or Pipe Dream?
European Journal of Arrhythmia & Electrophysiology. 2022;8(1):7-12 DOI: https://doi.org/10.17925/EJAE.2022.8.1.7
Several smart, connected and direct-to-consumer wearable devices capable of detecting cardiac arrhythmias have proliferated in the marketplace in the last decade. Increasingly, these devices are being marketed as “medical grade” in addition to “wellness” devices.1 New iterations of smartwatch and smartphone technology incorporate biosensors and advanced artificial intelligence (AI) algorithms equipped to diagnose cardiac arrhythmias; examples […]
Foreword – European Journal of Arrhythmia & Electrophysiology. 2021;7(1):1
European Journal of Arrhythmia & Electrophysiology. 2021;7(1):1
Welcome to a new issue of the European Journal of Arrhythmia & Electrophysiology. As the ongoing coronavirus disease 2019 (COVID-19) pandemic continues to provide unprecedented challenges for electrophysiologists and other healthcare providers who manage arrhythmias, we hope you find these topical articles interesting and useful. We begin with an editorial from Professor Hugh Calkins and […]
Journal articles and more to your inbox
Get the latest clinical insights from touchCARDIOSign me up!