Key result
Abnormal heart rate turbulence is a strong and independent predictor of adverse events after myocardial infarction, yielding a relative risk of 3.1 to 5.9 on multivariate analysis.
Why the study?
Does abnormal heart rate turbulence predict mortality and sudden death in post-myocardial infarction patients?
Does abnormal heart rate turbulence predict mortality and sudden death in post-myocardial infarction patients?
Effect estimate: RR 3.1-5.9
Heart rate turbulence is a strong, independent predictor of mortality after myocardial infarction and provides complementary risk stratification to LVEF, especially in patients with preserved ejection fraction.
May aid post-MI risk stratification; leaves open prospective validation before guiding therapy.
Heart rate turbulence (HRT) is the baroreflex-mediated short-term oscillation of cardiac cycle lengths after spontaneous ventricular premature complexes. HRT is composed of a brief heart rate acceleration followed by a gradual heart rate deceleration. In high risk patients after myocardial infarction (MI) HRT is blunted or diminished. Since its first description in 1999 HRT emerged as one of the most potent risk factors after MI. Predictive power of HRT has been studied in more than 10,000 post-infarction patients. This review is intended to provide an overview of HRT as risk-predictor after MI.
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Zuern et al. (2011) conducted a review in Myocardial Infarction (n=10,000). Abnormal Heart Rate Turbulence (HRT) vs. Normal Heart Rate Turbulence was evaluated on Adverse events (total mortality, cardiac mortality, and sudden death) (RR 3.1-5.9). Abnormal heart rate turbulence is a strong and independent predictor of adverse events after myocardial infarction, yielding a relative risk of 3.1 to 5.9 on multivariate analysis.
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