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Influence of cardiac‐resynchronization therapy on heart rate and blood pressure variability: 1‐year follow‐up
Author(s) -
Piccirillo Gianfranco,
Magrí Damiano,
Carlo Silvia,
De Laurentis Tiziana,
Torrini Alessia,
Matera Sabrina,
Magnanti Marzia,
Bernardi Leda,
Barillà Franco,
Quaglione Raffaele,
Ettorre Evaristo,
Marigliano Vincenzo
Publication year - 2006
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2006.01.008
Subject(s) - medicine , cardiology , heart rate variability , heart failure , cardiac resynchronization therapy , blood pressure , implantable cardioverter defibrillator , sudden cardiac death , sudden death , heart rate , spectral analysis , electrocardiography , ejection fraction , physics , quantum mechanics , spectroscopy
Background: Several studies have shown that cardiac‐resynchronization therapy (CRT) improves haemodynamic function, cardiac symptoms, and heart rate variability (HRV) and reduces the risk of mortality and sudden death in subjects with chronic heart failure (CHF). In subjects with CHF, power spectral values for the low‐frequency (LF) component of RR variability ≥13 ms 2 , are associated with an increased risk of sudden death. Aims and methods: To assess whether spectral indexes obtained by power spectral analysis of HRV and systolic blood pressure (SBP) variability could predict malignant ventricular arrhythmias in patients with severe CHF treated with an implantable cardioverter–defibrillator (ICD) alone or with ICD+CRT. In addition, changes in non‐invasive spectral indices using short‐term power spectral analysis of HRV and SBP variability during controlled breathing in 15 patients with CHF treated with an ICD alone and 16 patients receiving ICD+CRT, were assessed pre‐treatment and at 1 year. Results: Arrhythmias necessitating an appropriate ICD shock were more frequent in subjects who had low LF power. CRT improved all spectral components, including LF power. Conclusions: Low LF power values predict an increased risk of malignant ventricular arrhythmias; after 1 year of CRT most non‐spectral and spectral data, including LF power, improved. Whether these improvements lead to better long‐term survival in patients with CHF remains unclear.