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 journalArticle

Abstract

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
Volume76
Issue number3
DOIs
Publication statusPublished - 2012

Fingerprint

Arrhythmogenic Right Ventricular Dysplasia
Heart Rate
Implantable Defibrillators
Sudden Cardiac Death
Ventricular Fibrillation
Ventricular Tachycardia
Regression Analysis
Ambulatory Electrocardiography
Syncope
Electrocardiography
Guidelines

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Association of heart rate variability with arrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia. / Battipaglia, Irma; Scalone, Giancarla; Macchione, Andrea; Pinnacchio, Gaetano; Laurito, Marianna; Milo, Maria; Pelargonio, Gemma; Bencardino, Gianluigi; Bellocci, Fulvio; Pieroni, Maurizio; Lanza, Gaetano A.; Crea, Filippo.

In: Circulation Journal, Vol. 76, No. 3, 2012, p. 618-623.

Research output: Contribution to journalArticle

Battipaglia, I, Scalone, G, Macchione, A, Pinnacchio, G, Laurito, M, Milo, M, Pelargonio, G, Bencardino, G, Bellocci, F, Pieroni, M, Lanza, GA & Crea, F 2012, 'Association of heart rate variability with arrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia', Circulation Journal, vol. 76, no. 3, pp. 618-623. https://doi.org/10.1253/circj.CJ-11-1052
Battipaglia, Irma ; Scalone, Giancarla ; Macchione, Andrea ; Pinnacchio, Gaetano ; Laurito, Marianna ; Milo, Maria ; Pelargonio, Gemma ; Bencardino, Gianluigi ; Bellocci, Fulvio ; Pieroni, Maurizio ; Lanza, Gaetano A. ; Crea, Filippo. / Association of heart rate variability with arrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia. In: Circulation Journal. 2012 ; Vol. 76, No. 3. pp. 618-623.
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abstract = "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.",
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AU - Battipaglia, Irma

AU - Scalone, Giancarla

AU - Macchione, Andrea

AU - Pinnacchio, Gaetano

AU - Laurito, Marianna

AU - Milo, Maria

AU - Pelargonio, Gemma

AU - Bencardino, Gianluigi

AU - Bellocci, Fulvio

AU - Pieroni, Maurizio

AU - Lanza, Gaetano A.

AU - Crea, Filippo

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N2 - 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.

AB - 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.

KW - Arrhythmogenic right ventricular cardiomyopathy/dysplasia

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KW - Sudden cardiac death

KW - Sustained ventricular tachycardia

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