Higher total mean SDNNi derived from remote monitoring was significantly associated with the occurrence of lethal arrhythmic events in patients with an implantable cardioverter defibrillator (132.9 vs 93.5, P=0.0013).
Observational (n=33)
No
Does time-domain HRV analysis through remote monitoring predict lethal arrhythmic events in patients with an ICD?
Time-domain HRV analysis (SDNNi) via remote monitoring can identify ICD patients at high risk for lethal arrhythmic events like VT/VF.
Absolute Event Rate: 132.9% vs 93.5%
p-value: p=0.0013
We prospectively collected device and heart rate data through remote monitoring (RM) of patients with an implantable cardioverter defibrillator (ICD). The objective was to identify the predictors of lethal arrhythmic events (VT/VF).Thirty-three patients (mean age: 50 years) with ICDs with functionality of heart rate variability (HRV) analysis were divided into two groups VT/VF (+), VT/VF (-) . Clinical, device (ventricular lead impedance; amplitude of ventricular electrogram), and HRV data were compared between the two groups. The NN interval-index (SDNNi) was calculated for every 5 minutes, and the mean, maximum, minimum, and standard deviation of SDNNi during the 24-hour period were used.During the observation period of 13 ± 10 months, 10 patients experienced VT/VF events. Total mean, max, and min SDNNi were higher in the VT/VF (+) than the VT/VF (-) group (132.9 ± 9.3 versus 93.5 ± 6.1, P = 0.0013; 214.6 ± 10.6 versus 167.0 ± 7.0, P = 0.0007; 71.2 ± 7.5 versus 43.9 ± 4.9, P = 0.0047). On logistic regression analysis, a total mean SDNNi of 100.1, max SDNNi of 185.0 and min SDNNi of 52.0 as cut-off values for prediction of a VT/VF event demonstrated significant receiver operating characteristic (ROC) curves (AUC = 0.86, P = 0.0007; AUC = 0.84, P = 0.0005; AUC = 0.78, P = 0.0030). The max ΔSDNNi, i.e., difference from baseline SDNNi, and min ΔSDNNi in 7 and 28 days preceding VT/VF events were significant predictors of VT/VF events.Time-domain HRV analysis through a RM system may help identify patients at high risk of lethal arrhythmic events; in addition, it may help predict the occurrence of lethal arrhythmic events in specific cases.
Shirakawa et al. (Tue,) conducted a observational in Implantable cardioverter defibrillator (ICD) patients at risk of lethal arrhythmias (n=33). Heart rate variability (HRV) analysis via remote monitoring vs. Patients without VT/VF events was evaluated on Total mean SDNNi in patients with vs without VT/VF events (p=0.0013). Higher total mean SDNNi derived from remote monitoring was significantly associated with the occurrence of lethal arrhythmic events in patients with an implantable cardioverter defibrillator (132.9 vs 93.5, P=0.0013).