Frequency domain measures of heart rate variability before the onset of nonsustained and sustained ventricular tachycardia in patients with coronary artery disease.

Huikuri, Heikki V.; Valkama, Juhani; Airaksinen, Juhani; Seppänen, Tapio; Kessler, Kenneth M.; Takkunen, Juha T.; Myerburg, Robert J.

doi:10.1161/01.cir.87.4.1220

Cited by 218 publications

(118 citation statements)

References 25 publications

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“…during weaning, HRV was further reduced; the consequence was a significant increase in supraventricular dysrhythmias. Consistent with previous researchers, 16,17,[36][37][38][39][40] we found that LF power and HF power were predictive of the occurrence of ventricular and supraventricular ectopic beats, whereas VLF power was predictive of only the occurrence of ventricular ectopic beats. Huikuri et al 37 reported a significant decrease in HF power before the occurrence of ventricular tachycardia in patients with ischemic heart disease.…”

Section: Mean (Sd)supporting

confidence: 92%

“…Consistent with previous researchers, 16,17,[36][37][38][39][40] we found that LF power and HF power were predictive of the occurrence of ventricular and supraventricular ectopic beats, whereas VLF power was predictive of only the occurrence of ventricular ectopic beats. Huikuri et al 37 reported a significant decrease in HF power before the occurrence of ventricular tachycardia in patients with ischemic heart disease. Fei et al 39 reported significant changes in HRV immediately before the occurrence of tachyarrhythmias in patients with congestive heart failure; these investigators 40 later found a significant increase in the LF:HF ratio immediately before the occurrence of episodes of idiopathic ventricular tachycardia.…”

Section: Mean (Sd)supporting

confidence: 92%

“…decreased HRV has been described as arrhythmogenic. 16,17,[36][37][38][39][40] In previous studies, 16,17,38 increased sympathetic activity or decreased parasympathetic activity or both occurred before paroxysmal atrial fibrillation and atrial flutter in patients with underlying heart disease. Although our patients did not experience significant changes in VLF or HF power during weaning, VLF and HF power during weaning were predictive of the occurrence of supraventricular and ventricular dysrhythmias.…”

Section: Mean (Sd)mentioning

confidence: 88%

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Heart Rate Variability as a Predictor of Cardiac Dysrhythmias During Weaning From Mechanical Ventilation

Hammash

Moser

Frazier

et al. 2015

American Journal of Critical Care

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ACNP-bC, dNPBackground Weaning from mechanical ventilation to spontaneous breathing is associated with changes in the hemodynamic and autonomic nervous systems that are reflected by heart rate variability. Although cardiac dysrhythmias are an important manifestation of hemodynamic alterations, the impact of heart rate variability on the occurrence of dysrhythmias during weaning has not been specifically studied. Objectives To describe differences in heart rate variability spectral power and occurrence of cardiac dysrhythmias at baseline and during the initial trial of weaning from mechanical ventilation and to evaluate the impact of heart rate variability during weaning on occurrence of dysrhythmias. Method Continuous 3-lead electrocardiographic recordings were collected from 35 patients receiving mechanical ventilation for 24 hours at baseline and during the initial weaning trial. Heart rate variability was evaluated by using spectral power analysis. Results Low-frequency power increased (P = .04) and highfrequency and very-low-frequency power did not change during weaning. The mean number of supraventricular ectopic beats per hour during weaning was higher than the mean at baseline (P < .001); the mean of ventricular ectopic beats did not change. Low-frequency power was a predictor of ventricular and supraventricular ectopic beats during weaning (P < .001). High-frequency power was predictive of ventricular and supraventricular (P = .02) ectopic beats during weaning. Verylow-frequency power was predictive of ventricular ectopic beats (P < .001) only. Conclusion Heart rate variability power spectra during weaning were predictive of dysrhythmias.

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Section: Mean (Sd)supporting

confidence: 92%

Section: Mean (Sd)supporting

confidence: 92%

Section: Mean (Sd)mentioning

confidence: 88%

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Heart Rate Variability as a Predictor of Cardiac Dysrhythmias During Weaning From Mechanical Ventilation

Hammash

Moser

Frazier

et al. 2015

American Journal of Critical Care

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“…Apesar da maioria dos estudos ter avaliado pacientes após infarto agudo, parece que a disautonomia se desenvolve também em pacientes com atesrosclerose coronária crô-nica, independente da presença de IAM prévio 57,58 . Hayano e col 59 compararam a VFC com os achados na cineangiocoronariografia em 56 pacientes (55% deles sem IAM prévio) e observaram correlação entre a severidade das lesões angiográficas e a presença de diminuição da VFC, independente da localização das lesões coronárias e da função ventricular.…”

Section: Variabilidade Da Freqüência Cardíaca Após Infarto Do Miocárdiounclassified

Disfunção parassimpática, variabilidade da freqüência cardíaca e estimulação colinérgica após infarto agudo do miocárdico

Reis¹,

Bastos²,

Mesquita³

et al. 1998

Arq. Bras. Cardiol.

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A diminuição da variabilidade da freqüência cardíaca (VFC) constitui um importante fator prognóstico para o aparecimento de eventos cardíacos em indivíduos previamente sadios 1 e em portadores de cardiopatias [2][3][4] . Mais especificamente, em pacientes após infarto agudo do miocárdio (IAM), a redução da VFC já foi estabelecida como um fator de risco independente para eventos arrítmicos e mortalidade global 5,6 . Esta diminuição da VFC está relacionada à hiperatividade adrenérgica e diminuição da atividade parassimpática cardíaca encontradas ao longo da convalescência do IAM 7 . Embora o mecanismo que explique o aumento do risco, devido à disautonomia, não esteja claramente definido, existem evidências experimentais de um efeito protetor da estimulação vagal sobre a vulnerabilidade elétrica ventricular 8,9 correlacionando a hipoatividade parassimpática ao desenvolvimento de arritmia letais 10 . Entretanto, a diminuição da VFC, também, se correlaciona ao aumento da incidência de eventos cardíacos isquêmicos novos em indivíduos normais 1 e com mortalidade causada por falência cardíaca em pacientes após IAM 2,6 , sugerindo a existência de outros mecanismos além da modulação elé-trica, que explicam a relação entre VFC e mortalidade.A inibição do efeito adrenérgico cardíaco com o uso do betabloqueadores demonstrou ser capaz de reduzir a mortalidade de pacientes após IAM [11][12][13][14][15] . Entretanto, em relação à diminuição da atividade parassimpática, apesar das evidências experimentais 3,6 de sua relevância clínica após IAM 3,16 , ainda não existem estabelecidas medidas que, produzindo estimulação colinérgica, possam contribuir para a diminuição da mortalidade neste grupo de pacientes. Investigação da função autonômica cardiovascularA freqüência cardíaca (FC) está constantemente submetida a flutuações no tônus autonômico, determinadas 24,25 , os quais podem ser utilizados para detectar disfunção autonômica no diabetes mellitus 26 , no pós-IAM e em inúmeras outras condições [28][29] . Não sendo objetivo deste artigo revisão sobre os diversos testes autonômicos, sugerimos ao leitor interessado artigo sobre os mesmos, publicado por Castro e col em 1992 19,20 . Mais recentemente, grande atenção tem sido direcionada às flutuações espontâneas da FC, genericamente chamada de VFC [30][31][32] . Metodologia da análise da variabilidade da freqüência cardíacaO estudo da VFC é um método que nos permite analisar as flutuações que ocorrem durante períodos curtos ou prolongados (24h) 33,34 , tendo a vantagem de possibilitar uma avaliação não invasiva e seletiva da função autonômica. Este tipo de análise recebeu grande impulso após o estabelecimento da forte e independente relação entre VFC e mortalidade pós-IAM 3,6 . Entretanto, vários aspectos metodológicos ainda carecem de padronização universal 35,36 e o significado dos diferentes índices de VFC são mais complexos do que geralmente se acredita, podendo gerar conclusões incorretas e extrapolações precipitadas 34 . As chamadas medidas no domínio do tempo são índi-ces obti...

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“…The physiological implication of this reflex, namely, what role this reflex may play, is unknown. The possibility that the reflex cardioprotectively works thorough the reduction in myocardial oxygen demand or that the resultant high vagal tone prevents the development of serious ventricular arrhythmias is of interest [15,16]; however, there are few available data to support this so far.…”

Section: Exercise Induced Atrio-ventricular (Av) Block During Nuclearmentioning

confidence: 99%

Exercise induced atrio-ventricular (AV) block during nuclear perfusion stress testing: a case report

Sarullo

Accardo

D’Antoni

et al. 2016

Monaldi Arch Chest Dis

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Background. Exercise causes enhanced sympathetic discharge and results in physiologic tachycardia. However, in some patients with a diseased conduction system resulting from acute ischemia, exercise can precipitate heart block. Methods and results. In this report we describe a 51 years old male patient with transient advanced degree atrioventricular (AV) block developed during recovery from exercise stress testing, resolved after the administration of atropine. Nuclear perfusion imaging demostrated stress-induced ischemia of the inferior-apical segments, and recovery of perfusion in the images obtained at rest. Coronarography showed critical stenosis of the right coronary artery, which was treated by percutaneous coronary intervention (PCI) and drug eluting stent (DES) deployment. Conclusion. Nuclear myocardial perfusion imaging provides noninvasive evidence that transient ischemia of the infero- apical segment can result in advanced degree AV block in patient with critical severe right coronary disease.

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Frequency domain measures of heart rate variability before the onset of nonsustained and sustained ventricular tachycardia in patients with coronary artery disease.

Abstract: Spontaneous episodes of VT are preceded by changes in HRV in the frequency domain. Divergent dynamics of HRV before the onset of nonsustained and sustained VT episodes may reflect differences in factors that can facilitate the perpetuation of these arrhythmias.

Cited by 218 publications

References 25 publications

Heart Rate Variability as a Predictor of Cardiac Dysrhythmias During Weaning From Mechanical Ventilation

Heart Rate Variability as a Predictor of Cardiac Dysrhythmias During Weaning From Mechanical Ventilation

Disfunção parassimpática, variabilidade da freqüência cardíaca e estimulação colinérgica após infarto agudo do miocárdico

Exercise induced atrio-ventricular (AV) block during nuclear perfusion stress testing: a case report

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