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Heart Rate Variability Used as an Arrhythmia Risk Stratifier After Myocardial Infarction
Author(s) -
HOHNLOSER STEFAN H.,
KLINGENHEBEN THOMAS,
ZABEL MARKUS,
LI YI GANG
Publication year - 1997
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 - 10.1111/j.1540-8159.1997.tb06109.x
Subject(s) - medicine , heart rate variability , cardiology , myocardial infarction , sudden cardiac death , infarction , electrocardiography , vagal tone , heart rate , blood pressure
Heart rate variability (HRV) is considered to represent a noninvasive tool to assess cardiac autonomic tone at the level of the sinus node. It has been shown to have predictive power for risk assessment in patients surviving acute myocardial infarction. For this purpose, HRV should be assessed from 24‐hour Holter recordings obtained 7–10 days following the infarction. Although there is some recovery of HRV during the first 3 months after infarction, HRV remains reduced in postinfarction patients compared to values obtained in healthy individuals. Compared to assessment of left ventricular function as a risk marker, HRV is superior with respect to prediction of arrhythmic events and sudden death whereas both parameters yield comparative power for prediction of total cardiac mortality. Since the predictive power of HRV analysis alone is relatively low, the combined use of HRV measurements together with traditional risk markers (such as ventricular ectopic beats, signal‐averaged ECG, or left ventricular function) results in improved risk prediction with positive predictive accuracy in the range of 30%–50%.