Different Cut-Off Points of Decreased Heart Rate Variability for Different Groups of Cardiac Patients

Abstract

Background Heart rate variability HRV differs by the type and stage of the disease, by age, by environment, and so on. Criteria for normal, moderately changed and pathologic values of HRV lack for routine clinical work with different groups of cardiac patients.Methods Twelve time and frequency domain HRV variables were analysed from 24-h Holter ECG monitoring in 2578 ( ) consecutive patients of both sexes 57% male aged 15-91 ( ) mean 54" 13 years. Fifty-nine per cent of the patients were hospital out-patients, 15% came from the cardiac unit of an internal medicine department and 26% were undergoing stationary cardiac rehabilitation. Arrhythmias of aetiology other than coronary artery disease predominate in out-patients and coronary artery disease in in-patients. Limits of moderately and pathologically changed values were determined according to biostatistical principles.Results HRV differed by the age, sex and type of patients ( ) MANOVA P -0.001 . Heart rate and all HRV measures decreased with age. Females had a higher heart rate but more pronounced vagally modulated activity than males. Out-patients had better HRV than in-patients. The cut-off level for a ( pathologic standard deviation of the normal R -R interval a ) measure of overall HRV ranged from 75 ms in female out-patients to 44 ms in male patients from the cardiac unit. Different cut-points for 12 HRV measures were obtained for 12 sub-groups of patients. ConclusionIn view of the HRV differences between different cardiac patients, different limits of normal and decreased HRV are proposed for daily practice.

Heart rate variability in patients after cardiac valve surgery

“…Table 3 shows the differences in HRV variables between patients with an implanted artificial aortic vs. mitral valve. The cut-off point for normal overall HRV in general cardiology patient population was 93 ms for SDNN [4]. Twenty-two patients with an implanted aortic Table 2.…”

“…Furthermore, patients with an implanted artificial aortic valve have significantly longer R-R interval or lower sinus frequency, and significantly higher overall HRV referring to patients with an implanted artificial mitral valve. Apart from the fact that patients with an implanted artificial aortic valve were significantly older from the patients with an implanted artificial mitral valve, and it is known that physiologically HRV becomes decreased with age [3,4], there was no differences in all other analyzed patient characteristics such as pre-and postoperative EF and functional capacity.…”

“…In 1996, the Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology published their recommendations for standard measurements of HRV, physiological interpretation and their use in clinical practice [3]. Today in everyday clinical practice HRV is mainly used in risk stratification of manifestation malignant arrhythmia, and sudden death in patients with myocardial infarction (MI) [4]. Previous studies showed that after coronary artery bypass grafting (CABG), HRV becomes significantly decreased, even more significantly than in patients with MI [5,6].…”

Heart rate variability differences in post-myocardial infarction patients based on initial treatment during acute phase of disease

“…Occurrence of the cardiac autonomic disturbances in patients with MI is well documented [2]. However, direct comparison of HRV changes in postinfarction patients based on different treatment in acute phase of STEMI has not been reported in literature.…”

“…Most of the variables proposed by the Task Force on the HRV [3] were analyzed. Details have been published elsewhere [2]. Differences in HRV between the groups were tested by analysis of variance (ANOVA) and post hoc Tukey's test.…”