Measuring Heart Rate Variability in Patients Admitted with ST-Elevation Myocardial Infarction for the Prediction of Subsequent Cardiovascular Events: A Systematic Review

Abstract

Ischemic heart disease represents the leading cause of death, emphasizing risk stratification and early therapeutic intervention. Heart rate variability (HRV), an indirect marker of autonomic nervous system activity, was investigated extensively as a risk factor for adverse cardiovascular events following acute myocardial infarction. Thus, we systematically reviewed the literature to investigate the association of HRV parameters with mortality and adverse cardiovascular events in patients presenting with ST-elevation myocardial infarction (STEMI). Following the search process in the MEDLINE (PubMed), Embase, and Cochrane databases, nine studies were included in the final analysis. Lower time-domain HRV parameters and a higher ratio between power in the low-frequency (LF) band and power in the high-frequency (HF) band (LF/HF) were associated with higher all-cause mortality during follow-up, even in patients treated mainly with percutaneous coronary interventions (PCI). Although most studies measured HRV on 24 h ECG recordings, short- and ultra-short-term measures (1 min and 10 s, respectively) were also associated with an increased risk of all-cause mortality. Although data were discrepant, some studies found an association between HRV and cardiac mortality, reinfarction, and other major adverse cardiovascular events. In conclusion, HRV measurement in patients with STEMI could bring crucial prognostic information, as it was associated with an increased risk of all-cause mortality documented in clinical studies. More and larger clinical trials are required to validate these findings in contemporary patients with STEMI in the context of the new generation of drug-eluting stents and current antithrombotic and risk-modifying therapies.

Shortening heart rate variability measurement time to 1 minute using deep learning: Implication of real-time measurement of heart rate variability

“…Long-term recording (≥ 24 h) reliably assesses lower-frequency indices and is the reference standard for clinical evaluation because of its superior predictive validity [4,14]. Predictive outcomes such as mortality after acute MI and diabetic neuropathy are best assessed with long-term measurements, whereas changes in RR intervals during and immediately after abnormal respiratory events, such as obstructive sleep apnea, can be best assessed with ultrashort-term measurements [15–17].…”

“…Predictive outcomes such as mortality after acute MI and diabetic neuropathy are best assessed with long-term measurements, whereas changes in RR intervals during and immediately after abnormal respiratory events, such as obstructive sleep apnea, can be best assessed with ultrashort-term measurements [15][16][17].…”

Варіабельність Серцевого Ритму В Постінфарктних Хворих Із Серцевою Недостатністю

“…При стратифікації ризику хворих, які перенесли ІМ, важливу роль відіграє оцінка вегетативного дисбалансу [5,8,12,13]. Варіабельність ритму серця (ВРС) після ІМ має важливе прогностичне значення [5,7,12].…”

“…При цьому зниження варіабельності серцевого ритму тісно корелює з ризиком раптової смерті навіть більше, ніж із зниженням ФВ ЛШ та толерантності до фізичного навантаження. Встановлено, що ступінь зниження активності парасимпатичної частини вегетативної нервової системи прямо корелює з важкістю дисфункції ЛШ [3,4,8,14]. Стандартні відхилення ВСР і потужності VLF пов'язані з величиною ФВ як лівого, так і правого шлуночка, проте не корелюють з їх розмірами [6].…”

Alterations in heart rate variability before and after percutaneous coronary intervention in patients with ischaemic heart disease

“…[1,2] It is a vital non-invasive tool, an indirect marker to quantify cardiac autonomic nervous system activity. [1][2][3][4] Higher HRV indicates good compliance with environmental and physiological requirements while lower HRV shows the probable occurrence of cardiovascular morbidity threats and risks.…”