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

J Clin Monit Comput. 2010 Apr;24(2):125-9. doi: 10.1007/s10877-009-9218-4. Epub 2010 Jan 16.

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.

MeSH terms

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