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Diminished Short-Term Heart Rate Variability Predicts Inducible Ventricular Tachycardia FREE TO VIEW

Mahesh Bikkina; Martin A. Alpert; Rita Mukerji; Madhuri Mulekar; Bae-Yong Cheng; Vaskar Mukerji
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From the Division of Cardiology, University of South Alabama College of Medicine, Mobile

1998 by the American College of Chest Physicians

Chest. 1998;113(2):312-316. doi:10.1378/chest.113.2.312
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Purpose: The purpose of this study is to determine whether short-term heart rate variability (HRV) can be used successfully to predict inducible ventricular tachycardia (VT).

Methods: A high-speed (300 mm/s) electrocardiographs recording was obtained in 32 patients in the supine position prior to programmed ventricular stimulation. Beat-to-beat RR intervals (in milliseconds) were derived from an 11-beat strip (10 RR intervals). Logistic regression was used to study the relationship between several variables and a dichotomous dependent variable (inducible, clinical, or electrocardiographic evidence of VT).

Results: Of 32 patients, 12 had inducible VT (inducible VT group) and 20 had no clinical or electrocardiographic evidence of VT (control group). Mean short-term HRV values were significantly lower in those with inducible VT than in the control group in all patients (25±15 ms, n=12 vs 67±22 ms, n=20; p<0.0001) and in patients with coronary artery disease or congestive heart failure or both (22±13 ms, n=11 vs 63±23 ms, n=11; p<0.0001). For the group as a whole, short-term HRV was ≤50 ms in 11 of 12 patients (92%) with inducible VT, but was ≤50 ms in only 3 of 20 control subjects (15%; p<0.001). As a result of a stepwise selection procedure conducted within the logistic regression, only the short-term HRV was found to be predictive of inducible VT (p<0.0001).

Conclusion: Short-term HRV is significantly lower in subjects with inducible VT than in those without clinical or electrocardiographic evidence of VT. The probability of developing sudden death increases substantially when short-term HRV decreases below 50 ms.




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