Key result
Short nsVT runs link to higher turbulence onset than standard measurements in mild-to-moderate HF.
Why the study?
Does heart rate turbulence following nonsustained ventricular tachycardia correlate with prognostic markers in patients with heart failure?
Observational (n=27)
Does heart rate turbulence following nonsustained ventricular tachycardia correlate with prognostic markers in patients with heart failure?
Absolute Event Rate: 1.63% vs -1.7%
p-value: p=< 0.05
Heart rate turbulence is observable after short runs of nonsustained ventricular tachycardia in heart failure patients and correlates with ejection fraction and heart rate variability.
nsVT-triggered turbulence onset elevation may signal distinct autonomic responses in mild-moderate HF; hypothesis-generating and leaves open added prognostic value.
BACKGROUND: Heart rate turbulence (HRT) following isolated premature complexes is a baroreceptor-mediated prognostic marker. Short runs of spontaneous, nonsustained ventricular tachycardia (nsVT) exert a greater hemodynamic effect than extrasystoles and may trigger a more potent turbulence-like response (HRT(VT)), possibly related to other risk-related markers, such as heart rate variability (HRV), left ventricular ejection fraction (EF), and original HRT parameters (turbulence slope [TS] and turbulence onset [TO]). METHODS: We studied 27 patients with heart failure (HF) and nsVT (4-7 beats) on 24-hour Holter electrocardiographic recordings (mean age 58 +/- 3.6 years, EF 36%+/- 5.0%). Following nsVT, TS(VT) and TO(VT) were measured according to the original definitions. HRV, TS, and TO were also assessed. RESULTS: HRT(VT) parameters were related to HRV. A significant relation existed between TS(VT) and EF (r= 0.66, P < 0.05). HRT(VT) parameters were related to the originally described (TS and TO), whereas TO(VT) was higher than TO (1.63 +/- 1.6 vs -1.7 +/- 0.65, P < 0.05). CONCLUSIONS: In mild-to-moderate HF, turbulence is observed following short nsVT runs and is related to prognostically important HRV indexes and EF. HRT(VT) is similar to HRT but TO(VT) is shifted toward more positive values than TO. HRT(VT) might be prognostically significant.
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Flevari et al. (2007) conducted an observational in Heart failure and nonsustained ventricular tachycardia (n=27). Short runs of nonsustained ventricular tachycardia (nsVT) vs. Isolated premature complexes was evaluated on Turbulence onset (TO) (p=< 0.05). In patients with mild-to-moderate heart failure, turbulence onset following short nsVT runs was significantly higher than standard turbulence onset (1.63 vs -1.7, P<0.05).
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