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March 1, 2024Internal Medicine0 citationsOpen Access

Evaluation of Autonomic Nervous System Through Spectral Analysis in Patients with Ischemic Heart Failure: A Systematic Review

GPGiovanni-Paul PortelliISIulia-Cristina StănicăACAna Ciobanu

Key Result

Heart rate variability power spectral indices are useful assessment tools for diagnosing heart failure and stratifying the risk of arrhythmic events or sudden death in patients with ischemic heart failure.

Study Design

Type

Systematic Review

Structured PICO

Does power spectral analysis of ECG Holter monitoring improve diagnosis and risk stratification in patients with ischemic heart failure?

P
Population
A systematic review of 36 studies evaluating the use of power spectral analysis of ECG Holter monitoring to assess the autonomic nervous system in adult patients with ischemic heart failure.
E
Exposure
Power spectral analysis of ECG Holter monitoring (Heart Rate Variability parameters)
O
Outcome
Diagnosis of heart failure, risk stratification of sudden death or arrhythmias, and evaluation of treatmentssurrogate

Power spectral analysis of ECG Holter monitoring provides valuable prognostic information regarding autonomic imbalance, arrhythmic risk, and sudden death in patients with ischemic heart failure.

Limitations

  • Most included studies focused mainly on heart failure with reduced ejection fraction, limiting applicability to preserved or mid-range ejection fraction.
  • Frequent ectopic beats can make heart rate variability study and power spectrum analysis unreliable.
  • Potential errors in ECG Holter recording can arise from random noise.
  • Existing studies focus mainly on heart failure with reduced ejection fraction, with limited data on preserved or mid-range ejection fraction

Abstract

Abstract Heart failure is one of the most complex pathologies and most prevalent diseases, with around 64 million people affected globally (2% of the total adult population). In the initial phase of heart failure, studies have shown that the autonomic nervous system is in a state of imbalance, with an increase in the influence of the sympathetic nervous system on the heart. Persistence of long-term activation of the autonomic nervous system produces a decrease in the levels of myocardial catecholamines and also promotes down-regulation of beta-1 receptors. This article is a systematic review of papers from four well-known and important scientific databases on the subject of power spectral analysis of ECG Holter monitoring in patients with heart failure. The PRISMA technique was used to identify the most relevant articles on this subject, and their results were presented based on importance of their use for the diagnosis of heart failure, for risk stratification of sudden death or arrhythmias, for the evaluation of certain treatments used, or for other possible pathophysiological mechanisms involved in the evolution of the disease.

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Cite This Study

Portelli et al. (2024) conducted a systematic review in Ischemic heart failure. Power spectral analysis of ECG Holter monitoring was evaluated. Heart rate variability power spectral indices are useful assessment tools for diagnosing heart failure and stratifying the risk of arrhythmic events or sudden death in patients with ischemic heart failure.

synapsesocial.com/papers/6a2212ee5c15637a505805echttps://doi.org/10.2478/inmed-2024-0275
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