Association of heart rate variability with arrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia

Irma Battipaglia, Giancarla Scalone, Andrea Macchione, Gaetano Pinnacchio, Marianna Laurito, Maria Milo, Gemma Pelargonio, Gianluigi Bencardino, Fulvio Bellocci, Maurizio Pieroni, Gaetano A. Lanza, Filippo Crea

Research output: Contribution to journalArticlepeer-review


Background: Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is associated with an increased risk of sudden cardiac death (SCD). Risk stratification of ARVC/D patients, however, remains an unresolved issue. In this study we investigated whether heart rate variability (HRV) can be helpful in identifying ARVC/D patients with increased risk of arrhythmic events. Methods and Results: We studied 30 consecutive patients (17 males; 45.4±18 years) with ARVC/D, diagnosed according to guideline criteria; 15 patients (50%) had received an implantable cardioverter defibrillator (ICD) for primary SCD prevention. HRV was assessed on 24-h ECG Holter monitoring. The primary endpoint was the occurrence of major arrhythmic events (SCD, sustained ventricular tachycardia (VT), ICD therapy for sustained VT or ventricular fibrillation (VF)). During the follow-up period (19±7 months), no deaths occurred, but 5 patients (17%) experienced arrhythmic events (4 VTs and 1 VF, all in the ICD group). All HRV parameters were significantly lower in patients with, compared with those without, arrhythmic events. Low-frequency amplitude was the most significant HRV variable associated with arrhythmic events in univariate Cox regression analysis (P=0.017), and was the only significant predictor of arrhythmic events in multivariable regression analysis (hazard ratio 0.88, P=0.047), together with unexplained syncope (hazard ratio 16.1, P=0.039). Conclusions: Our data show that among ARVC/D patients HRV analysis might be helpful in identifying those with increased risk of major arrhythmic events.

Original languageEnglish
Pages (from-to)618-623
Number of pages6
JournalCirculation Journal
Issue number3
Publication statusPublished - 2012


  • Arrhythmogenic right ventricular cardiomyopathy/dysplasia
  • Heart rate variability
  • Sudden cardiac death
  • Sustained ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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