Heart rate variability patterns before ventricular tachycardia onset in patients with an implantable cardioverter defibrillator

Federico Lombardi, Alberto Porta, Maurizio Marzegalli, Stefano Favale, Massimo Santini, Antonello Vincenti, Angelo De Rosa

Research output: Contribution to journalArticlepeer-review

Abstract

Time- and frequency-domain analysis of heart rate variability (HRV) has been proven effective in describing alteration of autonomic control mechanisms and in identifying patients with increased cardiac and arrhythmic mortality. Patients with implantable cardioverter defibrillators offer the opportunity to evaluate HRV patterns before ventricular tachycardia (VT) and under control conditions. We therefore analyzed time- and frequency-domain parameters of short-term HRV and power-law behavior of RR interval time series at rest, at 15 to 30 minutes, and immediately before VT. In comparison to control conditions, lower values of mean cycle length duration and total power were observed before VT. Spectral analysis indicated that the low- to high-frequency ratio was significantly higher (5.5 ± 0.6 vs 2.8 ± 0.3) immediately before VT than during rest. Both findings were consistent with the shift of sympathovagal balance toward sympathetic predominance and reduced vagal tone. Before VT, a more negative value of the scaling exponent β of the power-frequency relation (-1.57 ± 0.04 vs -1.33 ± 0.04) also confirmed the presence of an altered HRV pattern in comparison to controls. Thus, both abnormal autonomic modulation and dynamic patterns of HRV seem to characterize the minutes before arrhythmia onset in these patients. Copyright (C) 2000 Excerpta Medica Inc.

Original languageEnglish
Pages (from-to)959-963
Number of pages5
JournalThe American Journal of Cardiology
Volume86
Issue number9
DOIs
Publication statusPublished - Nov 1 2000

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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