Heart Rate Versus Heart Rate Variability in Risk Prediction after Myocardial Infarction

Abstract

Heart Rate versus Heart Rate Variability. Introduction: The aim of this study was to evaluate and compare heart rate and heart rate variability (HRV) in risk prediction after acute myocardial infarction (MI) and to evaluate the effect of beta‐blocker treatment on the prognostic performance of heart rate and HRV. Methods and Results: Three hundred sixty‐six patients underwent 24‐hour Holter recording 1 to 6 days after an MI. HRV was expressed as the standard deviation of all normal‐to‐normal intervals. Left ventricular systolic function was evaluated using the wall motion index. Half of the patients were taking a beta‐blocker at the time of Holter recording. Mean follow‐up was 44 months (median 34) after MI. By the end of follow‐up, 82 patients had died. Mortality at 1 and 3 years was 12.5% and 22.6%, respectively. HRV, heart rate, wall motion index, number of ventricular premature beats per hour, and ventricular tachycardia were all significantly (P < 0.05) associated with mortality in univariate analysis, independent of beta‐blocker therapy. In multivariate Cox analysis, only heart rate, wall motion index, number of ventricular premature beats per hour, and age had independent prognostic value (P < 0.001). In any model, including heart rate, HRV had no predictive value. Conclusion: The prognostic information of HRV is contained completely in heart rate, which carries prognostic information further than that of HRV. This result was independent of beta‐blocker treatment. (J Cardiovasc Electrophysiol, Vol. 14, pp. 168‐173, February 2003)

Is it possible to predict hypotension during onset of spinal anesthesia in elderly patients?

“…First, the patients in this study were generally much older than the patients in the other studies and HRV decreases with increasing age [24]. Second, our patients had a higher resting HR, which also decreases HRV [25]. The HRV values are comparable to values obtained from other elderly patients [12].…”

Resting Heart Rate in Cardiovascular Disease

“…Depressed HR variability is associated with the risk of life-threatening arrhythmias in patients after AMI (45). There is some suggestion that HR variability assessed very early after AMI may not add prognostic information beyond that of HR alone (46). However, others have shown that HR variability is strongly predictive after AMI (47,48), even when assessed during the first 7 days (49).…”

Frecuencia cardíaca y riesgo cardiovascular

“…Sin embargo, un estudio demostró que la variabilidad de la FC determinada por Holter no aportaba información adicional a la propia FC media 37 .…”