In patients with acute anterior wall myocardial infarction, heart rate variability correlates inversely with QT dispersion, suggesting abnormal autonomic modulation of ventricular repolarization.
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Supports autonomic-repolarization link in acute MI; hypothesis-generating and requires prospective validation before any clinical application.
Background Heart rate variability (HRV) and QT dispersion are new and promising noninvasive indices for postinfarction risk stratification. The relationship between measures in patients with acute myocardial infarction (AMI) is unknown. Methods We analyzed short‐term HRV and standard electrocardiogram recordings for QT dispersion in 56 patients with first Q‐wave anterior wall AMI. Results All frequency domain measures of HRV correlated inversely with the magnitude of QT dispersion. The correlations were relatively stronger for rate‐corrected (−0.46 to −0.59) than for original values (−0.37 to −0.5) of QT dispersion. Similarly, the average normal cardiac cycle length (average NN) computed from HRV recordings correlated weakly and inversely with the magnitude of noncorrected QT dispersion (r =−0.29). Conclusions The inverse relationships between QT dispersion and both NN interval and HRV found in the present study suggest impaired adaptation of ventricular repolarization to changes in heart rate in AMI patients. Abnormal autonomic modulation of ventricular repolarization may thus result in increased QT dispersion. This finding may provide some insight into the mechanism underlying increased risk of sudden death after AMI. A.N.E. 1999; 4(2):152–157
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Mazur et al. (1999) studied this question.
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