Key result
A bootstrap rhythmometric procedure applied to 7-day Holter monitoring revealed that circadian components were most significant for all HRV indexes, with the 12-hour ultradian component most relevant.
Observational (n=22)
Long-term 7-day Holter monitoring analyzed with a bootstrap rhythmometric procedure reveals significant circadian, infradian, and ultradian components in heart rate variability indexes among heart failure patients.
Supports rhythmometric HRV assessment in heart failure; leaves open its prognostic role pending prospective validation.
Heart rate variability (HRV) markers have been widely used to characterize the autonomous regulation state of the heart from 24-h Holter monitoring, but long-term evolution of HRV indexes is mostly unknown. A dataset of 7-day Holter recordings of 22 patients with congestive heart failure was studied. A rhythmometric procedure was designed to characterize the infradian, circadian, and ultradian components for each patient, as well as circadian and ultradian fluctuations. Furthermore, a bootstrap test yielded automatically the rhythmometric model for each patient. We analyzed the temporal evolution of relevant time-domain (AVNN, SDNN, and NN50), frequency-domain (LF, HF, HFn, and LF/HF), and nonlinear (alpha(1) and SampEn) HRV indexes. Circadian components were the most significant for all HRV indexes, but the infradian ones were also strongly present in NN50, HFn, LF/HF, alpha(1), and SampEn indexes. Among ultradian components that one corresponding to 12 h, was the most relevant. Long-term monitoring of HRV conveys new potentially relevant rhythmometric information, which can be analyzed by using the proposed automatic procedure.
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Goya–Esteban et al. (2010) conducted an observational in congestive heart failure (n=22). 7-day Holter monitoring was evaluated on temporal evolution of HRV indexes. A bootstrap rhythmometric procedure applied to 7-day Holter monitoring revealed that circadian components were most significant for all HRV indexes, with the 12-hour ultradian component most relevant.