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Value of Heart Rate Variability to Predict Ventricular Arrhythmias in Recipients of Prophylactic Defibrillators with Idiopathic Dilated Cardiomyopathy
Author(s) -
GRIMM WOLFRAM,
HERZUM ILEANA,
MÜLLER HANSHELGE,
CHRIST MICHAEL
Publication year - 2003
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2003.00060.x
Subject(s) - medicine , cardiology , ejection fraction , implantable cardioverter defibrillator , ambulatory , ventricular tachycardia , dilated cardiomyopathy , heart rate variability , ventricular fibrillation , heart failure , electrocardiography , left bundle branch block , left axis deviation , right bundle branch block , heart rate , blood pressure
GRIMM, W., et al. : Value of Heart Rate Variability to Predict Ventricular Arrhythmias in Recipients of Prophylactic Defibrillators with Idiopathic Dilated Cardiomyopathy.This study investigated the relation between heart rate variability (HRV) measured as standard deviation of normal to normal RR intervals (SDNN) on baseline 24‐hour ambulatory electrocardiogram (ECG) and subsequent appropriate implantable cardioverter defibrillator (ICD) interventions in 70 patients with idiopathic dilated cardiomyopathy (IDC) in whom ICDs were implanted prophylactically in the presence of a low left ventricular ejection fraction (LVEF). During43 ± 26months of follow‐up, 26 of 70 (37%) study patients with IDC received one or more appropriate ICD interventions for sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) documented by electrograms stored in the ICD. Mean SDNN at ICD implant was94 ± 33 ms. No difference was found between patients with(90 ± 25 ms)versus without(96 ± 37 ms)appropriate ICD interventions for VT or VF during follow‐up. Multivariate Cox regression analysis of baseline clinical characteristics including age, gender, LVEF, NYHA functional class, nonsustained VT on Holter, history of syncope, left bundle branch block, baseline medication and HRV revealed LVEF as the only significant predictor of arrhythmia. These findings do not support the use of HRV measured as SDNN on 24‐hour ambulatory ECG to select patients with IDC for prophylactic ICD therapy. (PACE 2003; 26[Pt. II]:411–415)