Heart rate variability patterns before ventricular tachycardia onset in patients with an implantable cardioverter defibrillator

Lombardi, Federico; Porta, Alberto; Marzegalli, Maurizio; Favale, Stefano; Santini, Massimo; Vincenti, Antonello; Rosa, Angelo de la

doi:10.1016/s0002-9149(00)01130-9

Cited by 90 publications

(61 citation statements)

References 27 publications

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“…[5][6][7][8][9][10][25][26][27] Our study provides further evidence that ETS exposure is associated with cardiac autonomic dysregulation, which may be an intermediate step in the pathway to cardiac instability. 4,28 Our observations are in agreement with the findings of Pope, who described a short-term decrease in all HRV domains after acute exposure to ETS, but with relatively high standard errors in HF. 12 LF, which is considered to represent both sympathetic and parasympathetic activities, 29 was lower in subjects with higher ETS exposure.…”

Section: Discussionsupporting

confidence: 92%

Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study

Dietrich

Schwartz

Schindler

et al. 2007

International Journal of Epidemiology

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Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for cardiovascular diseases and death, and autonomic dysfunction (specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk. This study tests the hypothesis that ETS exposure reduces HRV in the general population and discusses possible pathways. Methods This cross-sectional study was conducted between 2001 and 2003 and is part of the SAPALDIA (Swiss CohortStudy on Air Pollution and Lung Diseases in Adults) study. The analysis included 1218 randomly selected non-smokers aged 50 and above who participated in 24-h electrocardiogram recordings. Other examinations included an interview, investigating health status (especially respiratory and cardiovascular health and health relevant behaviours and exposure to ETS) and measurements of blood pressure, body height and weight. ResultsSubjects exposed to ETS at home or at work for more than 2 h/day had a difference of À15% in total power (95%CI: À26 to À3%), low frequency power (À28 to À1%), low/high frequency ratio (À26 to À3%) and À18% (À29 to À4%) in ultralow frequency power of HRV compared with subjects not exposed to ETS at home or work. We also found a 2.7% (À0.01 to 5.34%) higher heart rate during the recording in exposed subjects.Conclusions Exposure to ETS at home and work is associated with lower HRV and with higher heart rate in an ageing population. Our findings suggest that exposure to ETS increases cardiac risk through disturbances in the autonomic nervous system.

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Section: Discussionsupporting

confidence: 92%

Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study

Dietrich

Schwartz

Schindler

et al. 2007

International Journal of Epidemiology

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“…An abnormally activated sympathetic and altered parasympathetic tonus associated with increased concentration of circulating norepinephrine (NE), profound peripheral vasoconstriction, attenuated cardiovascular reflexes, and down-regulation of adrenergic nerve terminals play a pivotal role in the progression of pump failure (4-6). Sympathetic nervous system activation in heart failure, as indexed by elevated NE levels, higher muscle sympathetic nerve activity and reduced HRV, is associated with pathologic ventricular remodeling, increased arrhythmias, sudden death, and increased mortality (7)(8)(9)(10)(11)(12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

The preserved autonomic functions may provide the asymptomatic clinical status in heart failure despite advanced left ventricular systolic dysfunction

Kocaman

Taçoy²,

Özdemir³

et al. 2010

Anadolu Kardiyol Derg

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Objective: Autonomic dysfunction is an important marker of prognosis in congestive heart failure (CHF) and may determine the symptoms and progression of CHF. The aim of our study was to investigate whether preserved autonomic function assessed by heart rate variability (HRV) analyses is related to absence of CHF symptoms despite prominently reduced systolic function. Methods: The study had a cross-sectional observational design. Fifty patients with left ventricular ejection fraction (EF) below 40% were enrolled. The patients were divided into two groups according to their CHF symptomatic status as Group 1 (NYHA functional class I, asymptomatic group) and Group 2 (NYHA functional class≥ II, symptomatic group). Plasma C-reactive protein (CRP), N-terminal proB-type natriuretic peptide (NT-proBNP) levels, echocardiographic parameters and HRV indices were measured while the patients were clinically stable in each group. Possible factors associated with the development of CHF symptoms were assessed by using multiple regression analysis. Results: Baseline clinical characteristics and left ventricular EF were similar in the two groups. Serum CRP (15±21 vs 7±18 mg/L, p=0.011) and NT-proBNP levels (1935±1088 vs 1249±1083 pg/mL, p=0.020) were significantly higher in symptomatic group. The HRV parameters (SDNN: 78±57 vs 122±42 ms, p=0.001; SDANN: 65±55 vs 84±38 ms, p=0.024; SDNNi: 36±41 vs 70±46 ms, p<0.001; triangular index [Ti]: 17±12 vs 32±14, p<0.001) were also significantly depressed in symptomatic group. When multiple regression analysis was performed, only HRV indices of autonomic function were significantly associated with the asymptomatic status (SDNN, OR: 1.016, 95%CI: 1.002-1.031, p=0.028; SDNNi, OR: 1.030, 95%CI: 1.008-1.052, p=0.006; TI, OR: 1.088, 95%CI: 1.019-1.161, p=0.011). Conclusion: Preserved autonomic functions were shown to be associated with absence of CHF symptoms independently of angiotensin converting enzyme inhibitor/angiotensin receptor blocker's treatment and BNP levels and may be protective against the development of CHF symptoms despite advanced left ventricular systolic dysfunction. (Anadolu Kardiyol Derg 2010 December 1; 10(6); 519-25) Key words: Heart rate variability, systolic heart failure, preserved autonomic function, autonomic dysfunction, clinical symptoms, regression analysis ÖZET Amaç: Otonomik disfonksiyon konjestif kalp yetersizliğinde (KKY) prognozun önemli bir belirleyicisidir ve KKY'nin semptomlarını ve ilerlemesini öngörebilir. Çalışmamızın amacı belirgin olarak azalmış sistolik fonksiyonu olan hastalarda kalp hızı değişkenliği (KHD) ile belirlenen korunmuş otonomik fonksiyonun KKY semptomlarının yokluğu ile ilişkili olup olmadığının araştırılmasıdır. Yöntemler: Çalışma gözlemsel ve enine-kesitli olarak planlandı. Sol ventrikül ejeksiyon fraksiyonu (EF) %40'ın altında 50 hasta çalışmaya alındı. Hastalar KKY semptomatik durumlarına göre; Grup 1 (NYHA sınıf I, asemptomatik grup) ve Grup 2 (NYHA sınıf>=II, semptomatik grup) olmak üzere iki gruba ayrıldılar. Hastaların p...

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“…[12] A change in the balance between the sympathetic and the parasympathetic nervous system is associated with increased risk of arrhythmias such as ventricular fibrillation, resulting in sudden death of patients. [13][14][15] These deaths occur in spite of patients being on regular monitored treatment for CAD. Tsuji et al have demonstrated that all-cause mortality is also higher in these individuals with reduced HRV.…”

Section: Discussionmentioning

confidence: 99%

Alteration of heart rate variability in patients with coronary artery disease

Venkatesh¹,

Shenoy²,

Prakash³

2018

Natl J Physiol Pharm Pharmacol

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Background: Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity in India. There is a need to identify various risk factors leading to the onset and progression of the disease. Heart rate variability (HRV) analysis is one of the emerging non-invasive techniques to identify severity and prognosis of CAD. HRV is defined as the oscillation in the interval between consecutive heartbeats as well as the oscillations between consecutive instantaneous heart rates. Aims and Objectives: The objective of this study is to identify the variations in HRV in patients with CAD. Materials and Methods: A total of 30 male patients aged 40-65 years with CAD and 30 age and sex matched healthy adults, satisfying the inclusion and exclusion criteria were enrolled in the study. Results: The results of our study showed a higher parasympathetic activity determined by high-frequency power (HF) in control subjects as compared to cases. Sympathetic predominance was seen in cases as determined by low-frequency power (LF). LF/HF ratio was also significantly higher in cases indicating sympathetic predominance. Conclusion: Sympathetic predominance with lowered parasympathetic activity observed in the cases puts them at a higher risk of adverse cardiac events. An attempt needs to be made to incorporate improvement of HRV as a modality of treatment of CAD.

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Heart rate variability patterns before ventricular tachycardia onset in patients with an implantable cardioverter defibrillator

Cited by 90 publications

References 27 publications

Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study

Effects of passive smoking on heart rate variability, heart rate and blood pressure: an observational study

The preserved autonomic functions may provide the asymptomatic clinical status in heart failure despite advanced left ventricular systolic dysfunction

Alteration of heart rate variability in patients with coronary artery disease

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