In patients with congestive heart failure and reduced left ventricular function, dofetilide was effective in converting atrial fibrillation, preventing its recurrence, and reducing the risk of hospitalization for worsening heart failure. Dofetilide had no effect on mortality.
Frequency domain analysis of heart rate variability (HRV) has been proposed as a semiquantitative method for assessing activities in the autonomic nervous system. We examined whether absolute powers, normalized powers, and the low frequency-to-high frequency ratio (LF/HF) derived from the HRV power spectrum could detect shifts in autonomic balance in a setting with low sympathetic nervous tone. Healthy subjects were examined for 3 h in the supine position during 1) control conditions ( n = 12), 2) acute β-blockade ( n = 11), and 3) chronic β-blockade ( n = 10). Heart rate fell during the first 40 min of the control session (72 ± 2 to 64 ± 2 beats/min; P < 0.005) and was even lower during acute and chronic β-blockade (56 ± 2 beats/min; P < 0.005). The powers of all spectral areas rose during the first 60 min in all three settings, more so with β-blockade ( P < 0.05). LF/HF was found to contain the same information as powers expressed in normalized units. LF/HF detected the shift in autonomic balance induced by β-blockade but not the change induced by supine position. In conclusion, none of the investigated measures derived from power spectral analysis comprehensively and consistently described the changes in autonomic balance.
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