Heart rate turbulence for guiding electric therapy in patients with cardiac failure.

Abstract

BACKGROUND:

It is well-known that a reduction of the cardiac frequency variability, measurable with the Heart Rate Variability (HRV) system, is an indirect expression of the sympathetic-autonomic tone. Another index, Heart Rate Turbulence (HRT), has been recently suggested as a possible unit of measurement for the sympathetic-autonomic tone: this system allows to estimate the baro-reflex response of the carotid arteries to an early ventricular extra-systole by analysing heart rate variations induced by a premature beat.

METHODS AND RESULTS:

In our research we have analyzed this phenomenon in patients affected by moderate or severe cardiac failure. In particular, we divided 110 patients into two arms: subjects with or without a history of resuscitated arrhythmic death, that is, patients with high or low arrhythmic potential. In a detailed analysis of the sympathetic-autonomic tone, using both the above-mentioned parameters, HRV showed an irrelevant statistical difference between the two arms; on the contrary, HRT showed a significant statistical difference.

CONCLUSIONS:

If our conclusions will be confirmed by next larger reports, HRT could become a reliable index for screening the arrhythmic potential of patients affected by cardiac failure, to select the ones who need a defibrillator implantation.

• Authors: Giovanni Fazio, Filippo M Sarullo, Luciana D'Angelo, Monica Lunetta, Claudia Visconti, Gabriele Di Gesaro, Loredana Sutera, Giuseppina Novo, Salvatore Novo
• Journal: Journal of clinical monitoring and computing (J Clin Monit Comput) Vol. 24 Issue 2 Pg. 125-9 (Apr 2010) ISSN: 1573-2614 [Electronic] Netherlands
• PMID: 20082123 (Publication Type: Journal Article)

Topics

• Algorithms
• Arrhythmias, Cardiac (diagnosis, physiopathology, prevention & control)
• Diagnosis, Computer-Assisted (methods)
• Electric Countershock (methods)
• Electroencephalography (methods)
• Female
• Heart Failure (diagnosis, physiopathology, prevention & control)
• Heart Rate
• Humans
• Male
• Middle Aged
• Reproducibility of Results
• Sensitivity and Specificity
• Therapy, Computer-Assisted (methods)