Key result
The multipole method of HRV analysis predicted imminent ventricular tachycardia or fibrillation with 50% sensitivity, 91.6% specificity, and an 84.5% positive predictive value.
Why the study?
Does the multipole method of HRV analysis predict imminent ventricular tachyarrhythmias in ICD patients?
Observational (n=28)
Does the multipole method of HRV analysis predict imminent ventricular tachyarrhythmias in ICD patients?
The multipole method of HRV analysis provides highly specific prediction of imminent ventricular tachyarrhythmias in ICD patients, potentially allowing for early warning and preventive strategies.
BACKGROUND: Contemporary implantable cardiac defibrillators (ICD) enable storage of multiple, preepisode R-R recordings in patients who suffered from ventricular tachyarrhythmia (VTA). Timely prediction of VTA, using heart rate variability (HRV) analysis techniques, may facilitate the implementation of preventive and therapeutic strategies. AIM: To evaluate the novel multipole method of the HRV analysis in prediction of imminent VTAs in ICD patients. METHODS: We screened patients from the Biotronik HAWAI Registry (Heart Rate Analysis with Automated ICDs). A total of 28 patients from the HAWAI registries (phase I and II), having medical records, who had experienced documented, verified VTA during the 2-year follow-up, were included in our analysis. HRV during preepisode recordings of 4,500 R-R intervals were analyzed using the Dyx parameter and compared to HRV of similar length recordings from the same patients that were not followed by arrhythmia. RESULTS: Our study population consisted mainly of men 25 of 28 (89%), average age of 64.8 ± 9.4 years, 92% with coronary artery disease. HRV during 64 preevent recordings (2.3 events per patient on average) was analyzed and compared with 60 control recordings. The multipole method of HRV analysis showed 50% sensitivity and 91.6% specificity for prediction of ventricular tachycardia/ventricular fibrillation in the study population, with 84.5% positive predictive value. No statistically significant correlation was found between various clinical parameters and the sensitivity of imminent VTA predetection in our patients. CONCLUSION: The multipole method of HRV analysis emerges as a highly specific, possible predictor of imminent VTA, providing an early warning allowing to prepare for an arrhythmic episode.
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Rozen et al. (2013) conducted an observational in Ventricular tachyarrhythmia in ICD patients (n=28). Multipole method of heart rate variability (HRV) analysis vs. Control recordings not followed by arrhythmia was evaluated on Prediction of imminent ventricular tachycardia/ventricular fibrillation. The multipole method of HRV analysis predicted imminent ventricular tachycardia or fibrillation with 50% sensitivity, 91.6% specificity, and an 84.5% positive predictive value.
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